How elderly pneumonia use antibiotics

Professor Zhang, 81-year-old, in recent days are dizziness, nausea, vomiting, discomfort, a doctor came to me. After the inspection, I told him suffering from pneumonia.
"Wondered why I did not cough, fever and other respiratory symptoms, the final diagnosis was pneumonia, is not misdiagnosed» listen to people say that pneumonia is over the age of 80 elderly people died of the first cause of cancer mortality rate than even higher, if true Pneumonia is, how do I »" Professor Zhang with doubt and anxiety in the eyes asked.
Indeed, as Professor Zhang said, the pneumonia is very afraid of the elderly "killer", but the incidence is very subtle, and often the plank road repair, the cover of Chencang, wait until after the diagnosis, treatment has become very difficult.
It is well known that elderly heart, lung, kidney and other important organ recession, the lower immune function, very susceptible to respiratory infections and secondary pneumonia. If there is hypertension, hyperlipidemia, diabetes, heart disease and other diseases, heart and kidney function decline significantly speed up the pace. In such circumstances, once a Fengchuicaodong, infected with the pneumonia, heart failure can be rapidly emerging. Therefore, the elderly pneumonia high mortality rate.
It is worth noting that because of systemic response capacity of the elderly poor, often without the typical pneumonia symptoms, compared the incidence of concealment, generally no fever, cough, chest pain, chills, and other young people the main symptoms of pneumonia, but to some non-specific symptoms such as fatigue, Weakness, nausea, vomiting, diarrhea and other symptoms, many people also appear disturbance of consciousness, dehydration and other systemic symptoms, peripheral blood leukocytes are not increased, but more than half of that increase neutrophil. This brought to the diagnosis is difficult. Therefore, the experts stressed that the age-discovery and diagnosis of pneumonia is very important, which requires patients, especially elderly patients have a better understanding of the families of pneumonia common sense, on the other hand, conventional medical treatment for the elderly to X-ray to clear pneumonia The diagnosis.
As regards treatment, rational use of antibiotics is critical, not applications, will add to illness. Therefore, whether doctors or patients or relatives of patients with antibiotics must pay attention to choose the following questions:
1. Fungicide used. As the elderly organs recession, the lower immune function, the killing pathogens rely mainly on sterilization. So the elderly宜用fungicide, such as penicillin (such as penicillin), cephalosporins (such as cefazolin sodium), quinolones (such as cyproterone kill Star).
2. Avoid the use of aminoglycoside (such as kanamycin, etc.) and other toxic drugs. The elderly poor liver and kidney function than adults, adverse reactions to antibiotics is also higher than the young, the elderly must be based on the characteristics of the development programme administration, to avoid application of aminoglycoside toxicity of drugs, such as certain conditions need to use While reducing the use of.
More than 2:00 on the application of antibiotics other than pneumonia in the elderly bacterial infection of the disease, the same applies.
The following three points that I sum up years of clinical experience of antibiotics applications.
1. Mild to moderate pneumonia, not the basis of the disease; preferred treatment when penicillin, such as penicillin allergies are available erythromycin, lincomycin; can also be used first-generation cephalosporins (such as cefradine capsule), amino Effect of sugar type (such as kanamycin), quinoline Re ketone (such as cyproterone kill Star).
2. Mild to moderate pneumonia, cardiovascular disease, diabetes, chronic lung disease, and so on the basis of choice of second-generation cephalosporins such as (such as cephalosporins Ceftiofur oxime), aminoglycoside (such as kanamycin), Legionella infection With erythromycin or quinoline Re ketone (such as cyproterone-killing) drug.
3. Severe pneumonia in the choice of second-and third-generation cephalosporins (third-generation cephalosporins such as cefotaxime triazine) or β-lactam plus lactamase inhibitors, such as amoxicillin - clavulanic Acid, ammonia ticarcillin - sulbactam, oxygen piperazine - tazobactam, and so on.