Pneumonia - Treatment

Home care may be possible even in severe cases when there is good support and available home nursing services. Often, caregivers can even be trained to administer intravenous antibiotics and chest therapy to patients at home.

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Home Treatment

Most patients with mild pneumonia can be treated at home with oral antibiotics, typically amoxicillin. A well-conducted 2002 study suggested that children with mild bacterial pneumonia may do as well with three days versus five days of amoxicillin. This is important because shorter duration ensures better compliance.

The following tips are also suggested:

Patients should be sure to drink plenty of liquids.
Do not suppress a cough. Coughing is an important reflex for clearing the lungs. Some doctors advise taking expectorants, such as guaifenesin (Breonesin, Glycotuss, Glytuss, Hytuss, Naldecon Senior EX, Robitussin), to loosen mucus. There is no proof that any of these products make much difference in outcome.
Mild pain can be treated with aspirin (adults only), acetaminophen (Tylenol), or ibuprofen (Advil, Motrin).
For severe pain, codeine or other stronger pain relievers may be prescribed. It should be noted, however, that codeine and other narcotics suppress coughing, so they should be used with care in pneumonia. Such pain relievers often require monitoring.
A laboratory study reported that aromatic oils containing oregano, thyme, and rosewood destroyed S. pneumoniae. It is not known whether they have any effect on pneumonia in people, but they are harmless and pleasant in any case.
Patients should practice chest therapy.

Hospitalization Guidelines

Treatment. If the pneumonia is severe enough for hospitalization, the standard treatment is intravenous administration of antibiotics for five to eight days. In cases of uncomplicated pneumonia, many patients may require only two or three days of intravenous antibiotics followed by oral therapy. Antibiotics taken by mouth are prescribed when the patient has improved substantially or leaves the hospital.

Duration of Stay. In the past, patients remained in the hospital eight to 11 days, but hospital stays are shorter now in most cases. A 2002 study found that patients who were first treated in the emergency room were able to go home sooner than those admitted directly to a hospital room. The reason for this was that ER patients tended to be given the appropriate antibiotics and to be treated sooner than those in the hospital itself.

It is important to stress, in any case, that once patients have been hospitalized, they should remain there until all their vital signs are stable. Most patients become stabilized in three days. Many experts use seven variables to measure such stability and to determine if the patient can go home:

Temperature. (Opinions differ on temperature goal. Some experts believe that a patient can go home if the temperature levels drop to 101 degrees F. Stricter criteria would require that it be at or close to 98.6 degrees F.)
Respiration rate. (Goal is a normal breathing rate, although expert opinion differs on the degree of normality required to be discharged.)
Heart rate. (Goal is 100 beats per minute or less.)
Blood pressure. (Goal is systolic blood pressure of 90 mmHg or greater.)
Oxygenation. (Goal of oxygen levels in the blood determined by the physician.)
The ability to eat. (Goal is regular appetite.)
Mental function. (Goal is normal.)