Treatments for Chlamydia pneumoniae
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Book Excerpts: Treatment of Chlamydia pneumoniae
Treatments of Chlamydia pneumoniae: Online Medical Books
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Acute pneumonia:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
Antibiotics, oxygen, mechanical ventilation, increased fluid intake, bed rest, analgesics
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Pneumonia:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Antimicrobial therapy varies with the causative agent. Therapy should be reevaluated early in the course of treatment. Supportive measures include humidified oxygen therapy for hypoxemia, mechanical ventilation for respiratory failure, a high-calorie diet and adequate fluid intake, bed rest, and an analgesic to relieve pleuritic chest pain. Patients with severe pneumonia on mechanical ventilation may require positive end-expiratory pressure to facilitate adequate oxygenation.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Pneumocystis carinii pneumonia:
Treatment
(Professional Guide to Diseases (Eighth Edition))
PCP may respond to drug therapy with co-trimoxazole. Other agents used to treat PCP include pentamidine, trimethoprim-dapsone, clindamycin, primaquine, and atovaquone. Corticosteroids are frequently used as well. However, because of immune system impairment, many patients with PCP, who also have HIV, experience severe adverse reactions to drug therapy.
Supportive measures, such as oxygen therapy, mechanical ventilation, adequate nutrition, and fluid balance, are important adjunctive therapies. Oral morphine sulfate solution may reduce the respiratory rate and anxiety, thereby enhancing oxygenation.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Idiopathic bronchiolitis obliterans with organizing pneumonia:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Corticosteroids are the current treatment for BOOP, although the ideal dosage and duration of treatment remain topics of discussion. Relapse is common when steroids are tapered off or stopped. This usually can be reversed when steroids are increased or resumed. Occasionally, a patient may need to continue corticosteroids indefinitely.
Immunosuppressive-cytotoxic drugs, such as cyclophosphamide, have been used in the few cases of intolerance or unresponsiveness.
Oxygen is used to correct hypoxemia. The patient may need either no oxygen or a small amount of oxygen at rest and a greater amount when he exercises.
Other treatments vary, depending on the patient’s symptoms, and may include inhaled bronchodilators, cough suppressants, and bronchial hygiene therapies.
BOOP is very responsive to treatment and usually can be completely reversed with corticosteroid therapy. However, a few deaths have been reported, particularly in patients who had more widespread pathologic changes in the lung or patients who developed opportunistic infections or other complications related to steroid therapy.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Vitamin C deficiency:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Because scurvy is potentially fatal, treatment begins immediately to restore adequate vitamin C intake by daily doses of 100 to 200 mg vitamin C in synthetic form or in orange juice in mild disease and by doses as high as 500 mg/day in severe disease. Symptoms usually subside in 2 to 3 days; hemorrhages and bone disorders, in 2 to 3 weeks.
To prevent vitamin C deficiency, patients unable or unwilling to consume foods rich in vitamin C or those facing surgery should take daily supplements of ascorbic acid. The recommended daily allowance is 60 mg/day. Vitamin C supplementation may also prevent this deficiency in recently weaned infants or those drinking formula not fortified with vitamin C.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Pneumonia:
Treatment
(Handbook of Diseases)
Antimicrobial therapy varies with the causative agent. Therapy should be reevaluated early in the course of treatment.
Supportive measures include humidified oxygen therapy for hypoxia, mechanical ventilation for respiratory failure, a high-calorie diet and adequate fluid intake, bed rest, and an analgesic to relieve pleuritic chest pain. Patients with severe pneumonia on mechanical ventilation may require positive end-expiratory pressure to facilitate adequate oxygenation.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Pneumocystis carinii pneumonia:
Treatment
(Handbook of Diseases)
PCP may respond to drug therapy with trimethoprim-sulfamethoxazole. Because of immune system impairment, many patients with HIV experience adverse reactions to drug therapy; diphenhydramine may be prescribed to reduce these adverse effects.
Pentamidine may be administered I.V. or in aerosol form. I.V. pentamidine is associated with a high incidence of severe toxic effects; the inhaled form is usually well tolerated. However, inhaled pentamidine may not effectively reach the lung apices. Adverse reactions associated with inhalation include metallic taste, pharyngitis, cough, bronchospasm, shortness of breath, rhinitis, and laryngitis.
Supportive measures, such as oxygen therapy, mechanical ventilation, adequate nutrition, and fluid balance, are important adjunctive therapies.
CLINICAL TIP: Oral or I.V. morphine sulfate may reduce the respiratory rate and anxiety, thereby enhancing oxygenation.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Bronchiolitis obliterans with organizing pneumonia, idiopathic:
Treatment
(Handbook of Diseases)
Corticosteroids are the treatment of choice for BOOP, although the ideal dosage and duration of treatment remain topics of discussion. In most cases, treatment begins with 1 mg/kg/day of prednisone for at least several days to several weeks; the dosage is then gradually reduced over several months to a year, depending on the patient’s response. Relapse is common when the steroid dosage is tapered off or stopped but usually can be reversed when the dosage is increased or resumed. Occasionally, a patient may need to continue corticosteroid therapy indefinitely.
Immunosuppressant-cytotoxic drugs, such as cyclophosphamide, have been used in the few cases in which the patient couldn’t tolerate or was unresponsive to corticosteroids.
Oxygen is used to correct hypoxemia. The patient may need either no oxygen or a small amount of oxygen at rest and a greater amount when he exercises.
Other treatments vary, depending on the patient’s symptoms, and may include an inhaled bronchodilator, a cough suppressant, and bronchial hygiene therapy.
BOOP is responsive to treatment and usually can be completely reversed with corticosteroid therapy. However, a few deaths have been reported, particularly in patients who had more widespread pathologic changes in the lungs or patients who developed opportunistic infections or other complications related to steroid therapy.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Assure coverage for resistantStreptococcus pneumoniae with vancomycin if there is a concernfor meningitis:
Management of Bacterial Meningitis
(Avoiding Common Pediatric Errors)
The broad-spectrum cephalosporins, cefotaxime and ceftriaxone, have traditionally been used as standard therapy for bacterial meningitis in infants
and children. However, in the past decade, penicillin-and cephalosporin-
resistant pneumococcal meningitis has been reported. In fact, cultures of
cerebrospinal fluid (CSF) were positive for 3 to 14 days after the initiation
of therapy. Therefore, in an attempt to identify an effective therapy, several antibiotic regimens including vancomycin, chloramphenicol, rifampin,
erythromycin, and imipenem, alone and in combination were given to
patients to identify an ideal anti–pneumococcal meningitis regimen.
Researchers concluded that on the basis of data from the pneumococcal
meningitis models and limited clinical experience, it was impossible to make
a single recommendation for initial empiric treatment that would be suitable
forallpatientswithsuspectedorprovenpneumococcalmeningitis.However,
the following guidelines could be considered in managing such patients:
• Physicians should be aware of the S. pneumoniae susceptibility patterns
in their area and request their hospital laboratories to perform dilution
susceptibility tests on any pneumococcal isolates recovered from usually
sterile body sites.
• Because penicillin-resistant pneumococci have been identified in many
areas of the United States, initial empiric therapy for bacterial meningitis
should be based on the possibility that it is the etiology of the patient's
illness. The recommended therapy is therefore ceftriaxone or cefotaxime
and vancomycin (60 mg/kg/day divided in four doses), in addition to
dexamethasone.
• A repeat lumbar puncture in patients with pneumococcal meningitis to
document eradication of the pathogen should be performed 24 to 36 hours
after the start of therapy, primarily in patients in whom the organism is
cephalosporin resistant.
• Alteration of the initial antimicrobial regimen should be based on the
clinical response of the patient and on the results of the CSF culture and
susceptibility studies from the second lumbar puncture. In the event that
the patients' clinical condition has worsened or that the follow-up Gram-
stained smear or culture of CSF indicates failure to substantially reduce
or eradicate the organism, substitution of rifampin for vancomycin in the
therapeutic regimen is recommended.
• Patients without complications should be treated for a minimum of
10 days.
» READ BOOK EXCERPT ONLINE »
Source: Avoiding Common Pediatric Errors, 2008
Community-acquired Pneumonia:
Management
(Pediatric Infectious Disease)
The management of the febrile tachypneic neonate suspected of having pneumonia
is similar to that of neonatal fever. Empiric intravenous antibiotics are
started until culture results are final. Empiric treatment usually consists of
ampicillin combined with gentamicin or a third-generation cephalosporin.
Treatment of
C. trachomatis is with oral erythromycin, 50 mg/kg per day in four divided doses for 2 weeks.
In the past, erythromycin was given to neonates exposed to
C. trachomatis at the time of delivery. Recently, there has been an association reported
between oral erythromycin and the subsequent development of hypertrophic
pyloric stenosis in infants younger than 6 weeks of age. The current
recommendation is to treat with oral erythromycin, 50 mg/kg per day in four
divided doses for 14 days all infants with chlamydial conjunctivitis and
pneumonia. Patients who are exposed at the time of delivery are not
presumptively treated, but rather monitored closely for the development of
disease. Routine screening of all pregnant women for sexually transmitted
disease is helpful in reducing disease by
C. trachomatis.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Infectious Disease, 2004
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