Published March, 07, 2021 Laura Moody RPh

What Is Pneumonia?

Pneumonia is a pathological process that affects lung tissue. It occurs in both adults and children. Inflammation of the lungs needs urgent treatment, even if it is not severe. 

The cause of pneumonia is mainly an infection. Therefore, the use of antibiotics for pneumonia in adults and children in combination with additional drugs is the basis of treatment.

The main symptoms of the disease are: 

• Fewer 100F and up to 104F (sometimes higher);
• Short breath; 
• Cough with yellowish or rusty sputum;
• Pain in the chest;
• Wheezing when breathing. 

Types Of Antibiotics

Antibiotics are divided according to their chemical structure into:

• Beta-lactam antibiotics are the most extensive group. It includes the following groups of drugs:
  • Penicillins: amoxicillin, ampicillin, penicillin, etc.;
  • Cephalosporins: ceftriaxone, cefazolin, cefepime, etc.;
  • Monobactams: aztreonam;
• Macrolides. These include azithromycin, clarithromycin, etc.
• Aminoglycosides: kanamycin, gentamicin, tobramycin, etc.
• Tetracyclines: doxycycline, tetracycline, etc.
• Lincosamides: clindamycin.

Of the above groups, beta-lactam antibiotics and macrolides are used to treat pneumonia.

The effectiveness of pneumonia treatment is evaluated 2-3 days after the start of treatment. Despite an improvement in the patient’s general condition, the antibiotic should not be discontinued or changed to another subspecies. The recommended course of antibiotics is essential to pass in full according to the doctor’s prescription. It will not allow bacteria to develop antibiotic resistance and prevent the development of complications of lung pathology in the near future.

For ease of use in adults and children, antibiotics come in different dosage forms. For adults, they are tablets and capsules; for children with lower respiratory tract lesions, suspensions are prescribed. Injectable forms are used at any age, but due to the procedure’s invasiveness, they are used more often in adult therapy.

Semi-synthetic Penicillins

Advanced penicillins are more effective against pneumonia than their predecessors. This group of antibiotics is predominantly used to treat uncomplicated pneumonia. [1]

An undoubted advantage of semi-synthetic penicillins is their low toxicity compared to other groups of antibiotics. That is why this group of drugs is often used to treat inflammation in adults and children, and pregnant women.

Penicillin antibiotics include oxacillin and cloxacillin, which are the most effective and fastest in treating pneumonia caused by staphylococci.

Amoxicillin is another popular antibiotic with extended antimicrobial properties. It is widely used in adults with community-acquired pneumonia.

Augmentin contains a combination of amoxicillin and clavulanic acid, which can effectively eliminate bacterial lung infection.

Macrolide Antibiotics

The macrolides group is most often prescribed as first-line drugs if the patient has an individual intolerance to penicillins. These antibiotics are active against atypical forms of the disease caused by intracellular membrane parasites, chlamydia, or mycoplasmas. Macrolides are also effective against gram-positive bacteria. [2]

The most widely used macrolide antibiotics are:

• azithromycin (Zithromax);
• clarithromycin (Klacid and );
• erythromycin (Erymax, Erythrocin, Erythroped);
• spiramycin;
• telithromycin (Ketek).

Sometimes erythromycin is used to treat lower respiratory tract infections. It is widely used to treat atypical forms of the disease.

The duration of treatment with erythromycin for uncomplicated pneumonia is usually from seven to ten days. A disadvantage of this drug is frequent side effects after its use. 

Cephalosporin Antibiotics

The cephalosporin group is usually used if the patient has been shown to have individual intolerance to macrolides. Typically, cephalosporins provide treatment for uncomplicated pneumonia.

There are four generations of cephalosporin antibiotics:

- First-generation drugs are used to treat lower respiratory tract infections (cephalexin)

- Second-generation medications include cefuroxime and cefoxitin, which are used to treat infections caused by various bacteria. Cefoxitin is the most used antibiotic from this group to treat pneumonia. [3]

- Third-generation antibiotics (cefotaxime, ceftazidime, cefoperazone) have broad antibacterial activity. Such drugs are used to treat inflammatory processes in the lungs in severe cases. [4]

- Fourth-generation antibiotic is cefepime. It is the most effective against gram-positive and gram-negative aerobic and anaerobic microorganisms and in the case of complicated pneumonia.

Cephalosporin antibiotics are used to treat severe and extremely severe pneumonia. As a rule, third- and fourth-generation drugs are used for this purpose. [5]

Drugs from this group are usually well tolerated by the human body. The exceptions may be patients with severe renal or hepatic impairment and older people.

Fluoroquinolone Antibiotics

The use of fluoroquinolones is usually recommended for allergic reactions to all other agents. This group is used to treat severe lower respiratory tract infections. 

Because of its broad spectrum of antimicrobial activity, this drug group is excellent for treating all forms of out-of-hospital pneumonia.

However, the use of early fluoroquinolones in community-acquired lower respiratory tract inflammation was limited because they were ineffective against pneumococcus.

Ofloxacin is most commonly used for the treatment of lower respiratory tract disorders that are not caused by pneumococcus. [6]

The most popular second-generation antibiotic is levofloxacin. 

Clinical studies confirm high efficacy and good tolerability of levofloxacin for the treatment of community-acquired pneumonia. [7]

Another effective medication from this group is sparfloxacin. However, despite its high antibacterial effectiveness, sparfloxacin has a notable side effect - increased skin sensitivity to ultraviolet rays. Therefore, sparfloxacin is used to treat pneumonia only if there are no alternatives. [8]

Carbapenem Antibiotics

Carbapenems are used in the treatment of inpatient lower respiratory tract inflammation. They are prescribed for complicated forms of pneumonia and septic processes. [9]

The most popular antibiotics from this group are:

• doribax
• doripenem
• ertapenem
• imipenem/cilastatin
• invanz
• meropenem

Pneumonia Treatment In Children

Antibiotics for pneumonia in children are used if the disease has bacterial nature. Antibiotic therapy eliminates the cause of the disease. Thus, it is a key element of treatment.

Like in adults, the treatment depends on the severity of the disease. Mild forms can be treated at home following all the doctor’s instructions. 

How Long Does Pneumonia Last After Antibiotics?

The length of treatment in adults and children depends on the severity of the disease and the type of the drug. For example, the length of treatment with azithromycin is 3 days, with amoxicillin - 7 days. [10]

Your doctor may change the duration of treatment depending on your health condition. 

You should not stop taking antibacterial drugs earlier than indicated by your doctor, as the next intake may be ineffective.