Pneumonia - Treatment

Highlights	Risk Factors	Prevention
Introduction	Diagnosis	Resources
Causes	Treatment	References
Symptoms	Medications
Prognosis	Surgery

Treatment

Patients with pneumonia are generally treated with:

Antibiotics
Respiratory support with oxygen, if needed

text continues below

Categorizing Severity and Determining the Need for Hospitalization

Up to 10% of all adult hospitalizations in the U.S. are due to pneumonia. Studies indicate that many patients are hospitalized unnecessarily for pneumonia and those patients could be released sooner. A number of strategies are being devised to determine when and which patients can be safely discharged. One approach for determining whether a patient should be hospitalized categorizes patients into five classes depending on risk factors for severity, with class 1 being the least severe (having less than 0.5% risk for death) and class 5 being the most severe (having at least a 10%death risk).

Ruling out the Least Severe Cases. The procedure for determining the need for hospitalization starts byselecting patients in the lowest risk groups (class 1 and 2) who can be discharged with outpatient care only. This can often be done with a simple physical examination, which can rule out a severe condition. Patients in low-risk categories have the following characteristics:

Under age 50 and not a patient in a nursing home
No other major illnesses are present
No serious symptoms are present such as altered mental state, breathing problems, bluish skin,very low blood pressure orvery high fever

Even these criteria, however, are flexible. Physiciansmust use their own judgment and take all factors into consideration. As examples, the following young people with signs of pneumonia should be hospitalized, even if they otherwise fit low-risk (class 1) categories:

Any infant under a month
Young adults with alcoholism or severe psychiatric conditions
Young adults or children with abnormal heart rhythms
Young adults or children who are vomiting heavily
Children who are dehydrated

Determining The Next Levels of Severity. If a patient is not in a class 1 category or does not appear toneed hospitalization, the next step is to determine which of the other four higher classes the patient fits into. This step involves assigning points to other findings, including:

Laboratory test results
X-ray findings
Demographics (Is the patient male or female? Does the patient live in anursing home?)

The points are added and the patients are scored:

Patients who score the lowest are assigned class II and III. They can usually be treated at home or need only to be hospitalized for 24 hours for observation.
Patients with higher scores are placed in classes IV and V, and are hospitalized.