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Suggest Better Medications For Pneumonia
Question: my mother has been in hospital and has had two bouts of pneumonia. She recovered from the first bout in intensive care as also had sepsis with it. She then contracted pneumonia again two weeks later and again was given meropenem for 10 days. The course has finished, the infection hasn't left her and the doctor says there is nothing he can do. She is 86 years old, previously living on her own and caring for my dad. Is there another, stronger drug we can try?
Brief Answer:
I have compiled a list of antibiotics we can/should try
Detailed Answer:
Hello and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. Honestly speaking, this depends on the type of infection and it does appear that your mother has been administered several antibiotics in the past making her resistant to numerous antibiotics. But with the provided information, I think your mother has developed resistance to most antibiotics.
If meropenam was prescribed, there could be a possibility of the infection being gram negative. As meropenam is supposed to be extremely potent in killing gram positive infections, either your mother does not have a gram positive infection or she has developed MRSA (methicillin-resistant staphylococcus Aureus) infection. Either way, it is difficult to comment on the possible infection type.
But I shall try my best to provide you with a list of antibiotics that are the strongest and best, but you may have to discuss with your doctor the type of infection your mother has (the source or type of bacteria).
1. Meropenem is very effective and potent, but is ineffective in MRSA (as explained earlier), especially with gram negative bacteria
2. Vancomycin: I would recommend trying this drug as it is often called 'last resort drug', and is effective with MRSA (if at all your mother does have this)
3. Linezolid: Also effective against MRSA, and also used as a drug of last resort
4. Piperacillin/tazobatam: Covers a large number of bacteria, and tazobactam is also effective in fighting resistance
5. Aztreonam: Very powerful against many forms of pneumonia
6. Tigecycline: Also very strong, and very effective against MRSA (also considered as a drug of last resort)
7. Cefepime: Broad spectrum of effect and can be very effective in many types of strong and resistant infections
8. Polymyxin B: Also strong against MRSA and can be tried as a last resort antibiotic
I would recommend all of the drugs to be tried individually to hope for a response, and please do not waste any more time and take this up with your doctor. I hope and pray we can find a solution in the list I have provided. Please feel free to write back to me for any further clarifications, I am always here to help.
Best wishes.
I have compiled a list of antibiotics we can/should try
Detailed Answer:
Hello and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. Honestly speaking, this depends on the type of infection and it does appear that your mother has been administered several antibiotics in the past making her resistant to numerous antibiotics. But with the provided information, I think your mother has developed resistance to most antibiotics.
If meropenam was prescribed, there could be a possibility of the infection being gram negative. As meropenam is supposed to be extremely potent in killing gram positive infections, either your mother does not have a gram positive infection or she has developed MRSA (methicillin-resistant staphylococcus Aureus) infection. Either way, it is difficult to comment on the possible infection type.
But I shall try my best to provide you with a list of antibiotics that are the strongest and best, but you may have to discuss with your doctor the type of infection your mother has (the source or type of bacteria).
1. Meropenem is very effective and potent, but is ineffective in MRSA (as explained earlier), especially with gram negative bacteria
2. Vancomycin: I would recommend trying this drug as it is often called 'last resort drug', and is effective with MRSA (if at all your mother does have this)
3. Linezolid: Also effective against MRSA, and also used as a drug of last resort
4. Piperacillin/tazobatam: Covers a large number of bacteria, and tazobactam is also effective in fighting resistance
5. Aztreonam: Very powerful against many forms of pneumonia
6. Tigecycline: Also very strong, and very effective against MRSA (also considered as a drug of last resort)
7. Cefepime: Broad spectrum of effect and can be very effective in many types of strong and resistant infections
8. Polymyxin B: Also strong against MRSA and can be tried as a last resort antibiotic
I would recommend all of the drugs to be tried individually to hope for a response, and please do not waste any more time and take this up with your doctor. I hope and pray we can find a solution in the list I have provided. Please feel free to write back to me for any further clarifications, I am always here to help.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr XXXXXXX
Your reply was very straightforward and clear, just one main question. How would they go about finding out what type of infection it was?
I feel that the treatment she has received is based on her age and would be quite different if she were younger. They state her infection markers are very high which suggests the antibiotics have not worked.
Incidentally she also has pyoderma on her leg and I imagine this would make the infection markers high'ish.
She is eating and drinking well, very lucid and concerned about her appearance.
I am also concerned that she has suffered with diorahea since being hospitalised and this cannot help her immune/nutrition levels.
Your reply was very straightforward and clear, just one main question. How would they go about finding out what type of infection it was?
I feel that the treatment she has received is based on her age and would be quite different if she were younger. They state her infection markers are very high which suggests the antibiotics have not worked.
Incidentally she also has pyoderma on her leg and I imagine this would make the infection markers high'ish.
She is eating and drinking well, very lucid and concerned about her appearance.
I am also concerned that she has suffered with diorahea since being hospitalised and this cannot help her immune/nutrition levels.
Brief Answer:
It as entirely my pleasure to be of assistance; culture examination
Detailed Answer:
Hello once again.
The type of infection-causing organism is found with the help of a culture test. In the case of a respiratory infection, the sputum sample is sent to the laboratory to conduct the culture and sensitivity examination. This test provide us with the following information:
+Confirms the infection
+Provides us with the name of the infection-causing organism
+The sample is tested against a number of antibiotics, and the result is provided to us (which antibiotic is sensitive and which one is resistant, how sensitive it is and which antibiotics are most suitable for the current infection, etc.)
The pyoderma will indeed make her white blood cells (markers to look for infection) rise slightly more, but not by a significant amount as the main rise will be due to the more stronger infection.
As for the diarrhoea, this is common with the use of antibiotics sir/ma'am. It would be best to also provide her with a safe balance of intravenous fluid. But maintaining her immune system/nutrition level will indeed be a risky task, but most doctor will be experienced to handle the situation.
I hope this information was explained in a manner best understood by you. Please feel free to write back to me for any further clarifications, I would be more than happy to help.
Best wishes.
It as entirely my pleasure to be of assistance; culture examination
Detailed Answer:
Hello once again.
The type of infection-causing organism is found with the help of a culture test. In the case of a respiratory infection, the sputum sample is sent to the laboratory to conduct the culture and sensitivity examination. This test provide us with the following information:
+Confirms the infection
+Provides us with the name of the infection-causing organism
+The sample is tested against a number of antibiotics, and the result is provided to us (which antibiotic is sensitive and which one is resistant, how sensitive it is and which antibiotics are most suitable for the current infection, etc.)
The pyoderma will indeed make her white blood cells (markers to look for infection) rise slightly more, but not by a significant amount as the main rise will be due to the more stronger infection.
As for the diarrhoea, this is common with the use of antibiotics sir/ma'am. It would be best to also provide her with a safe balance of intravenous fluid. But maintaining her immune system/nutrition level will indeed be a risky task, but most doctor will be experienced to handle the situation.
I hope this information was explained in a manner best understood by you. Please feel free to write back to me for any further clarifications, I would be more than happy to help.
Best wishes.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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