Name
PNEUMONIA, CHLAMYDIAL
DESCRIPTION
DETAIL
TYPENOTES
Medical Care: " C psittaci o Tetracycline or doxycycline is the treatment of choice. Continue treatment for 10-21 days. A longer course to prevent relapse is controversial. o Erythromycin is the alternative treatment, but this drug may be less efficacious in severe cases. " C pneumoniae o Doxycycline is the treatment of choice except in children younger than 9 years and pregnant women. Treatment should be continued for at least 10-14 days after defervescence. If symptoms persist, a second course with a different class of antibiotics is usually effective. o In outpatient settings, use doxycycline (100 mg PO bid) or tetracycline hydrochloride (500 mg PO qid). o In inpatient settings, use doxycycline hyclate (100 mg IV bid). o Alternatives include erythromycin (500 mg PO/IV qid) and newer macrolides such as azithromycin (500 mg PO/IV qd for 7-10 d) and clarithromycin (1 g PO qd [Biaxin XL] or 500 mg PO bid for 10 d). Newer macrolides are better tolerated than erythromycin. Shorter courses of the newer macrolides appear to be effective. o Telithromycin is the first antibiotic in a new class called ketolides and is approved by the US Food and Drug Administration for C pneumoniae pneumonia. It is more expensive than doxycycline. Telithromycin is a potent inhibitor of CYP3A4 and can cause potentially dangerous increases in serum concentrations of simvastatin, lovastatin, atorvastatin, midazolam, and other drugs. If telithromycin is used, statins should be withheld for the duration of therapy. o Fluoroquinolones, including levofloxacin (500 mg PO/IV qd for 10-14 d) and moxifloxacin (400 mg PO/IV qd for 10-14 d), also have some activity, although less than that of tetracyclines or macrolides. Gatifloxacin is no longer marked in the United States. " C trachomatis infant pneumonia o Treatment for infant pneumonia mirrors the treatment for conjunctivitis. The efficacy is approximately 80-90%. o Treat with erythromycin (50 mg/kg/d PO divided q6h for 10-14 d). o Doxycycline is contraindicated in children younger than 9 years. Surgical Care: Valve replacement may be required for patients with endocarditis.
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
X-RAY CHEST ( BRONCHITIS ), COMPLETE HAEMOGRAM, SPUTUM FOR CULTURE & SENSTIVITY TEST