Abstract
The clinical picture (fever, cough, sputum, auscultatory changes), peripheral blood parameters (leukocytosis, ESR) and radiological data are currently the criteria for suspecting bacterial pneumonia in patients with SARS CoV-2 infection and for indication of antibacterial treatment. The initiation of antibiotic therapy is empirical by taking into account the pathogens most likely involved in community-acquired pneumonia (Str pneumoniae, St. aureus, Kl. pneumoniae, Haemofillus influenzae, Mecoplasma pneumoniae, Chlamydia, Ps. aeruginosa). Beta-lactams (cephalosporins, carbapenems), protected beta-lactams, macrolides and fluoroquinolones are the most commonly administered groups, and the combinations of cephalosporins + macrolides and cephalosporins + fluoroquinolones constitute the most used groups of antibacterial treatment in order to include bacterial flora, gram-positive or gram-negative, and atypical.
Highlights
The initiation of antibiotic therapy is empirical by taking into account the pathogens most likely involved in community-acquired pneumonia
Antibioticele s-au prescris la toți pacienții cu formă medie și gravă din primele zile ale internării pe o durată de [8-12] zile (94,5% bolnavi);
Summary
7 – cu ceftriaxon și 1 cu meropenem, tratamentul cu 2 antimicrobiene au urmat 52 bolnavi (31 – asocierea cefalosporine+macrolide, 16 – ceftriaxon+ciprofloxacină/moxifloxacină, 5 – ceftriaxon+gentamicină), iar cu 3 preparate antimicrobiene din diverse grupe – 4 pacienți, însă nu s-au administrat concomitent ci s-a schimbat un antibiotic pe altul, la ineficiența primului. Factori etiologici la pacienții cu pneumonie comunitară internați în staționar cel mai frecvent sunt Streptococcus pneumoniae, Mycoplasma pneumoniae, Haemophilus influenza, Chlamydia pneumoniae, Legionella spp. Doxiciclina poate fi utilizată ca alternativă la macrolide sau fluorochinolone respiratorii, la pacienții cu interval QT prelungit, pentru a acționa asupra microorganismelor atipice precum Chlamydia pneumoniae, Legionella pneumophila și Mycoplasma pneumoniae.
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