Could Pneumonia Guidelines Be Making it Worse?

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Treatment guidelines issued by the Infectious Diseases Society of America may not be the best approach to battling drug-resistant pneumonia, according to a recent study. Why influenza sometimes evolves into pneumonia.When you come down with a case of pneumonia that lands you in the hospital, the Infectious Diseases Society of America (IDSA) has laid out some guidelines regarding the best course of treatment to ensure your recovery. It is likely that you have a type of pneumonia that has become drug-resistant if you’re hospitalized for the condition. Current guidelines call for immediate antibiotic treatment of patients at risk for this kind of multiple-drug-resistant infection. The guidelines state that patients should receive a regimen of three antibiotics.

Two of the drugs fight Gram-negative pathogens and one drug fights “methicillin-resistant Staphylococcus aureus,” or MRSA. In theory, at least one drug should be active against any likely infectious agent. However, according to a new study out of the University of Miami, intensive care patients with drug-resistant pneumonia may be more likely to die if the IDSA’s treatment guidelines are followed.

Researchers enrolled 303 patients at risk for drug-resistant pneumonia from four academic medical centers in the United States. Of those patients, 129 were treated according to the IDSA guidelines, while 174 received a different treatment.

How did both groups fare? The rate of survival after 28 days was 65% in the IDSA guideline group, but a much improved 79% in the group that didn’t adhere to the guidelines. The researchers concluded that the study results point to a need to revisit combination Gram-negative treatment.

Critics of the study, however, are quick to explain that the newstudy demonstrates high mortality rates in patients given recommended antibiotics as well as individualized antibiotics. Unfortunately, even in this age of sophisticated and powerful medications, adherence to the best guidelines can fail.

When you suffer from influenza, your lungs and the lining of the respiratory tract may be damaged. The tissues in these areas can become swollen and inflamed. Fortunately, the damage is rarely permanent — these tissues usually heal within a few weeks.

For healthy adults, influenza is typically not life-threatening. Most people are back on their feet within a week. For people who are already struggling with other illnesses, influenza can be very serious, with additional complications occurring.

Most of these complications usually come in the form of bacterial infections, because the body can be so weakened by influenza that its defenses against bacteria are low. Bacterial pneumonia is the most common serious complication of influenza. Talk to your doctor about all your options if you suffer from pneumonia at any time.

When Should You See a Doctor?

You want to see the doctor as soon as you suspect something more is going on after a flu or cold. If symptoms aren’t fading and others are lingering and cropping up after a week, see your doctor right away. Getting diagnosed and treated will help you recover and prevent spreading the illness any further to those around you—pneumonia is contagious, after all.


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