Treatment of Pneumonia Caused by Pneumococcus

The most common cause of community acquired pneumonia is pneumococcus and empirical therapy for community acquired pneumonia should always include an antibiotic which is effective against local strains of pneumococcus. But the ideal way of treatment is to start with an antibiotic which is not resistant to local strains and send for blood culture and antibiotic sensitivity test. After the antibiotic sensitivity test report is available, the antibiotic can be changed if required or continued if it is sensitive to the pneumococcus.

Generally antibiotics for treatment of pneumococcal pneumonia can be given by oral route or by parenteral route. Commonly used oral antibiotics are amoxicillin (1 gram every 8 hourly), a quinolone such as levofloxacin (500 mg once a day) and Telithromycin (800 mg once a day). Parenteral treatment of pneumonia can be either by ampicillin (1-2 gram IV or intravenously every 6 hourly), ceftriaxone (1 gram IV once or twice a day), quinolone such as gatifloxacin (400 mg IV every 24 hours), Imipenem (500 mg IV every 6 hourly) etc.

How long pneumococcal pneumonia should be treated?

There is no clear cut guideline for optimal treatment of pneumococcal pneumonia. The duration of therapy is generally guided by the response of the patient to the antibiotic therapy. And in absence of a clear cut guideline most of the doctors treat pneumococcal pneumonia for 5-7 days. Most experienced physician’s advice to start treatment with parenteral therapy, followed by oral antibiotic and observation of the patient for not more than 5 days once fever subsides. In this way duration of treatment do not generally cross 5-7 days.

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