(a) The drug of choice is penicillin given by intramuscular injection.
The dosage ranges from 600,000 units of procaine penicillin every 12 hours if the illness
is moderate to 1 million units of aqueous penicillin G given every 4 hours in an
intravenous infusion for a patient seriously ill. Continue penicillin treatment 72 hours
after the patient's temperature has returned to normal. If the patient is allergic to
penicillin, administer tetracycline or erythromycin.
(b) The patient should have bed rest, oxygen, fluids, and electrolytes.
In two to three weeks, the patient should have a follow-up chest x-ray.
(4) Prognosis. In treated groups, there is 95 percent recovery. In groups of
people who are untreated, 20 to 40 percent do not survive (usually in the under 2 age
group and the over 45 age group).
Section IV. OTHER CAUSES OF PNEUMONIA
Other causes of pneumonia include other bacteria, viruses, mycoplasmas,
pulmonary embolus, and atelectasis. The physical findings and x-ray evidence may be
similar. In order to treat a pneumonia case properly, it is important to determine the
cause by blood culture and sputum examination. Occasionally, other methods may be
necessary to determine the cause.
3-12. STAPHYLOCOCCAL PNEUMONIA
a. Predisposing Factors. A person with a respiratory tract viral infection can
contract this type of pneumonia. A debilitated patient such as a postsurgical patient
also may contract staphylococcal pneumonia.
b. Signs/Symptoms. Signs of consolidation (dullness and tubular breathing)
are infrequent, but pleural effusion (liquid in the pleural space) is common. Gram-
positive cocci (bacterial cells) help confirm that the patient has staphylococcal
c. Treatment. Initial treatment consists of a vigorous antibiotic which should be
a penicillin derivative other than penicillin G or ampicillin. If the patient is sensitive to
penicillin, the next drug of choice would be cephalothin given for 8 to 14 days and
administered intravenously or vancomycin twice a day administered intravenously.
d. Prognosis. There is 15 to 20 percent mortality. Whether or not the patient
recovers depends on his underlying general health and the effect of the drug
administered on the virus.