Treatment of Legionnaires Disease
Legionnaires’ disease is always treated with antibiotics. Treatment is usually started as soon as the disease is suspected, without waiting for confirmation. The antibiotics are often used to treat legionnaires. Sometimes a combination of antibiotics is used, especially if it is not yet certain whether the infection is due to legionella or to other germs (bacteria). Treatment with antibiotics lasts from a week to three weeks.
There are three major classes of antibiotics that are effective in treating legionellosis. These include
the fluoroquinolones such as levofloxacin (Levaquin), and moxifloxacin (Avelox).
the macrolides such as erythromycin, azithromyocin (Zithromax), and clarithromycin (Biaxin).
the tetracyclines including doxycycline (Vibramycin).
A new class of antibiotics (glycylcyclines) are also effective.
In severe cases of Legionnaires’ disease that seem more resistant to a single antibiotic, a second drug called rifampin (Rifadin) may be added. The choice of antibiotic is often dependent on the patient’s clinical state. Zithromax and Levaquin are particularly effective because of decreased gastrointestinal irritation, higher potency, better penetration into tissue, and once-daily dosing.
Oxygen is commonly given. This is because pneumonia inflames the lungs and makes them work less well. This can cause oxygen levels to drop. Breathing in extra oxygen makes it easier for the lungs to do their job. If you are very unwell, especially with a breathing problem such as lung infection (pneumonia), you are likely to be unable to drink enough fluids.
Intensive care with supportive treatments, such as assisted ventilation, may be needed if the pneumonia is severe.
Many people completely recover with treatment, but most will need care in the hospital. Elderly people and those with other health conditions are particularly vulnerable to the effects of Legionnaires’ disease. They may also be given fluids and electrolytes through a vein in their arm to prevent dehydration.
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