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General principles

Authoring team

Specific antimicrobial therapy may be supplemented by:

  • oxygen for hypoxia; ventilation in severe hypoxia. 35% oxygen is administered, but if previous CO2 retention is suspected then 24-28% should be used and arterial blood gases monitored.
  • fluids for dehydration
  • analgesics - NSAIDs and paracetamol - for mild pleuritic pain; more potent analgesics such as morphine if pain is severe - but beware hypercapnia.
  • supervised coughing and, later, chest physiotherapy to encourage expectoration is valuable. Nebulised saline may help expectoration.

Routes of administration:

  • severe cases - parenteral
  • change to oral treatment when there is a clinical improvement
  • mild or moderate - oral route usually satisfactory

Duration of treatment:

  • 7 to 10 days is usually sufficient. Continue for at least 3 days after the fever has settled. But:
  • staph aureus and Klebsiella - continue until temperature is consistently normal, then continue for 2 weeks.
  • mycoplasma - 2 to 3 weeks.

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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