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Outpatient parenteral antibiotic therapy (OPAT) is used to administer non-oral antibiotics (usually intravenously) without the need for ongoing hospitalisation. OPAT is particularly useful for people who are not severely ill but do require a prolonged course of treatment that cannot be given in oral form. [ 1 ]
The IV and oral forms of steroids have been found to be equivalent. [20] Antibiotics are often used but will only help if the exacerbation is due to an infection. [21] Antibiotics are indicated when a patient notes increased sputum production, [6] purulent sputum, [6] increased dyspnea, [6] has an elevated white count, or is febrile.
Nasal aPDT addresses the issues of antibiotic-induced resistance in multiple ways. As a site-specific therapy, it does not interfere with the overall microbiome because it is not systemically administered. Moreover, phenothiazinium photosensitizers can target negatively charged bacterial cells leaving zwitterionic host tissues unharmed. [80]
Carbapenems are less commonly used in the treatment of community-acquired pneumonia, as community-acquired strains of the most common responsible pathogens (Streptococcus pneumoniae, Haemophilus influenazae, atypical bacteria, and Enterobactericeace) are typically susceptible to narrower spectrum and/or orally administered agents such as ...
Colistin, also known as polymyxin E, is an antibiotic medication used as a last-resort treatment for multidrug-resistant Gram-negative infections including pneumonia. [7] [8] These may involve bacteria such as Pseudomonas aeruginosa, Klebsiella pneumoniae, or Acinetobacter. [9]
Additional consideration is given to the treatment setting; most patients are cured by oral medication, while others must be hospitalized for intravenous therapy or intensive care. Current treatment guidelines recommend a beta-lactam, like amoxicillin, and a macrolide, like azithromycin or clarithromycin, or a quinolone, such as levofloxacin.
MRSA can be eradicated with a regimen of linezolid, [87] though treatment protocols vary and serum levels of antibiotics vary widely from person to person and may affect outcomes. [88] The effective treatment of MRSA with linezolid has been successful [87] in 87% of people. Linezolid is more effective in soft tissue infections than vancomycin.
A systematic review of 32 randomised controlled trials with 6,078 participants with acute respiratory infections compared procalcitonin (a blood marker for bacterial infections) to guide the initiation and duration of antibiotic treatment, against no use of procalcitonin. Among 3,336 people receiving procalcitonin-guided antibiotic therapy ...