The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
Community-acquired pneumonia are most often treated with macrolides (clarithromycin, azithromycin), doxycycline, or fluoroquinolones (levofloxacin, moxifloxacin, gatifloxacin). Streptococcus pneumoniae cases account for up to 70% of all community-acquired pneumonia. There is a growing concern in the medical community about drug resistance to penicillin, macrolides, beta-lactams, and trimethoprim-sulfamethoxazole.
In a review of 15 trials, researchers concluded that it may be safe to treat community-acquired pneumonia with antibiotics for seven days versus 10-14 days. This may reduce bacterial resistance, lower costs, and improve compliance.
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Hospital- or nursing home-acquired pneumonia is most commonly treated with a combination therapy, such as a beta-lactam (ceftizoxime, cefotaxime) plus macrolide (clarithromycin, azithromycin) or a fluoroquinolone (moxifloxacin, levofloxacin, gatifloxacin).
Prescription Medications
Antibiotics in General
Antibiotics work by killing bacteria or preventing them from growing and reproducing. The choice of antibiotic depends on the type of bacteria that is believed to be causing the infection. The way the antibiotic is administered (by mouth or intravenously) depends on how ill you are and whether you have any other medical conditions that put you at risk for severe infection or complications.
You must take every dose of an antibiotic. Even if youre feeling better, be sure to complete the course of medicine recommended by your healthcare provider.
Antibiotics may cause allergic reactions in susceptible people. You should discontinue your medication and immediately contact your doctor if you experience:
Many antibiotics interact with other medicines. To avoid any dangerous or uncomfortable drug interactions, tell your doctor about all other medicines you are using.
Diarrhea
”This may be severe; in which case, you should contact your doctor.
Nausea
Vomiting
Bleeding problems”Check with your healthcare provider if you notice easy bruising, increased bleeding, or spontaneous bleeding.
Some beta-lactam antibiotics interfere with oral contraceptives.”Use another form of contraception while you are taking these medications.
Some cephalosporins should not be taken with alcohol.”Check with your doctor.
Some beta-lactam antibiotics interfere with sugar levels in
diabetic
patients.”Check with your doctor before you change your dose of insulin or other diabetes drugs.
Take enoxacin and norfloxacin on an empty stomach. If you are taking antacids or sucralfate, dont take them within two hours of taking a fluoroquinolone. Take these drugs with a full glass of water. The others may be taken either on an empty stomach or with meals.
Possible side effects include:
Increased sensitivity to sun
Some people taking these medications feel dizzy or lightheaded. Dont drive or participate in potentially hazardous activities until you know how these medications will affect you.
For levofloxacin”Check with doctor before taking this drug if you are taking medications for your heartbeat.
For enoxacin”Check with your doctor before taking this drug along with caffeinated products.
Inflamed, torn tendons
Low blood sugar in people with diabetes
If you have low blood potassium levels, you may develop an irregular heartbeat.
Always take these medicines with a full glass of water. While its preferable to take erythromycin on an empty stomach, a lot of people experience stomach upset. If you do, try taking it with food. Take azithromycin one hour before or two hours after meals. Clarithromycin can be taken without regard to meals; take clarithromycin two hours apart from zidovudine. To avoid heart complications, dont take clarithromycin while you are also taking astemizole, cisapride, or pimozide.
Possible side effects include:
Erythromycin can rarely cause
jaundice
(a yellow cast to the whites of the eyes and the skin).
Be sure to take tetracycline with food to avoid stomach upset. Wait two hours between taking antacids or milk and taking a dose of tetracycline. Doxycycline and minocycline can be taken without regard to food or milk. Always take these medicines with a full glass of water.
While you are taking tetracycline, tell your healthcare provider or dentist prior to any medical or dental procedures or surgeries.
Possible side effects include:
Stomach cramps, burning
Diarrhea
Nausea
Vomiting
Tetracycline can cause discolored teeth in children.
When pregnant women take tetracycline, their children may have discolored teeth.
Increased sun sensitivity
Some people taking minocycline feel dizzy or lightheaded.”Dont drive or participate in potentially hazardous activities until you know how these medications will affect you.
Decreased effectiveness of oral contraceptive”Use another form of contraception while your are taking tetracyclines.
These medicines are usually not prescribed for infants less than three months old. Elderly people have an increased risk of skin and bleeding problems with these medications, especially if they are already using diuretics. Always take the medicines with a full glass of water.
Possible side effects include:
Bleeding problems, including increased bleeding, easy bruising, slow healing (Delay dental procedures if possible.)
Increased sensitivity to sun
Itching
Skin rash
Nausea
Vomiting
Diarrhea
Stomach cramps
Some people taking these drugs feel dizzy or lightheaded.”Dont drive or participate in potentially hazardous activities until you know how these medications will affect you.
Aminoglycosides are usually given through an intravenous needle into your vein.
Because aminoglycosides can affect the kidneys, hearing, balance, and muscles, be sure to tell your healthcare provider if you already have conditions that affect those body systems. Depending on your condition, a different antibiotic may be chosen.
These medications are given through an intravenous needle into your vein.
These drugs can be hard on the kidneys and on hearing and balance. Tell your healthcare provider if you already have conditions that affect those body systems. If you do, another drug may be preferable.
Antifungal medications are available to fight fungal pneumonias. You must take every dose of an antifungal. Even if youre feeling better, be sure to complete the course of medicine recommended by your healthcare provider.
Antifungal medications may cause allergic reactions in susceptible individuals. You should discontinue your medication and immediately contact your healthcare provider if you experience:
Skin rash
Hives
Itching
Puffy face
Puffiness around eyes
Difficulty breathing
Many antifungal medications interact with other medicines. Make sure your healthcare provider knows about all other medicines you are using to avoid any dangerous or uncomfortable drug interactions. Be sure that your healthcare provider knows about any other medical conditions you may have. You are more at risk for complications from antifungal medications if you have the following conditions:
Abnormally low or abnormally high levels of stomach acid
Take these medicines with a full glass of water and a full meal.
Do not take these medications with astemizole (Hismanal), cisapride (Propulsid), dofetilide (Tikosyn), or terfenadine (Seldane); these combinations can cause heart problems. Dont drink alcohol while youre using antifungal medications. Take antacids and H-2 blocking medicines at least two hours after taking your antifungal dose.
Possible side effects include:
Increased sun sensitivity (especially to the eyes)
Fever
Chills
Skin rash
Itching
Diarrhea
Nausea
Vomiting
Over-the-Counter Medications
Acetaminophen
Common brand name includes:
Tylenol
Acetaminophen
can be helpful in relieving some of the fever and pain associated with pneumonia. Its also safe to give to children. Do not take a larger dose than is recommended by your healthcare provider. Do not drink alcoholic beverages while you are taking acetaminophen.
Ibuprofen
Common brand names include:
Motrin
Advil
Ibuprofen
can also help relieve some of the fever and pain associated with pneumonia. Ibuprofen may irritate the stomach, you should take this medicine with food. Drinking alcoholic beverages while you are taking ibuprofen can increase the chance that it will irritate your stomach.
On rare occasions, people have allergic reactions to ibuprofen. If you notice a new skin rash, difficulty breathing, or puffiness or swelling in your face or around your eyes, stop taking ibuprofen and immediately contact your healthcare provider.
Special Considerations
Whenever you are taking a prescription medication, take the following precautions:
Take them as directed”not more, not less, not at a different time.
Do not stop taking them without consulting your doctor.
Dont share them with anyone else.
Know what effects and side effects to expect, and report them to your doctor.
If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
Plan ahead for refills so you dont run out.
References
American Lung Association website. Available at:
http://www.lungusa.org
. Accessed July 17, 2008.
Bjerre LM, Verheij TJ, Kochen MM. Antibiotic for community acquired pneumonia in adult outpatients.
Cochrane Database Syst Rev.
2004;2:CD002109
Carratala J, Martin-Herrero JE, Mykietiuk A, Garcia-Rey C. Clinical experience in the management of community-acquired pneumonia: lessons from the use of fluoroquinolones.
Clin Microbiol Infect.
2006;12:2-11
Kabra SK, Lodha R, Pandey RM. Antibiotics for community acquired pneumonia in children.
Cochrane Database Syst Rev.
2006;3:CD004874
National Heart, Lung, and Blood Institute
website. Available at:
http://www.nhlbi.nih.gov/
. Accessed July 17, 2008.
Schmidt-Ioanas M, Lode H. Treatment of pneumonia in elderly patients.
Expert Opin Pharmacother.
2006;7:499-507
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9/18/2007 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance
: Li JZ, Winston LG, Moore DH, Bent S. Efficacy of short-course antibiotic regimens for community-acquired pneumonia: a meta-analysis.
Am J Med.
2007;120:783-790.
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11/21/2007 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance
: Yahar D, Paul M, Fraser A, Sarid N, Leibovi L. Efficacy and safety of cefepime: a systematic review and meta-analysis.
Lancet Infect Dis.
2007;7:338-348.
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provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a
medical condition.
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Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
