Treatment of Community-Acquired or Hospital-Acquired Pneumonia

When a patient is suspected of having hospital-acquired or community-acquired pneumonia and presents with symptoms like shortness of breath, the selection of the antibiotics is based on three major factors: patient characteristics (such as the history of smoking, chronic illness, age, and history of the disease), laboratory results, and physical examination findings. For physicians, the treatment decision should start by evaluating the necessity for hospitalization, particularly by using established prediction tools for amplified mortality. For instance, physicians can combine the Pneumonia Severity Index (a tool for forecasting the increased mortality probability or risk) with clinical judgment (Reyburn, Henley, & Chang, 2006). The need for hospitalization will help physicians establish whether inpatient or outpatient therapy should be used. Guidelines from various scientific studies show that empiric treatment with doxycycline, fluoroquinolones, and macrolides should be used for outpatients. Those admitted should be shifted from parenteral antibiotic drugs to oral antibiotics if their initial symptoms improve.

However, it is also critical to consider various genetic, cultural, and ethnic differences in patients to ensure the efficacy and safety of the drugs. For genetic disposition, physicians must take note of the different rates of drug metabolization in patients. There are three groups of metabolizers, including poor metabolizers, extensive metabolizers, and rapid metabolizers. If given a standard dose, poor metabolizers tend to slowly metabolize the medication and stand the risk of facing side effects and overdose. For rapid metabolizers, the efficacy of the drug is likely to be slower if given in a normal dose, meaning that a higher dose is required. In terms of ethnic and cultural differences, physicians must consider the unique practices of each population of patients, such as the type of herbal medications consumed and things like dietary plans (McFadden, n.d.). Usually, herbal preparations interact with prescribed medications, impacting the efficacy of the latter significantly.

References

McFadden, J. (n.d.). Cultural, environmental, and genetic influences on drug therapy. Jones & Bartlett Learning, LLC.

Reyburn, S. W., Henley, E., & Chang, L. F. (2006). Diagnosis and treatment of community-acquired pneumonia. American Family Physician, 73(3), 442-450.

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