PNEUMONIA TREATMENT
If you are a healthy individual and you get pneumonia, should you be admitted to the hospital for safety’s sake? Or is it ok to be sent home with antibiotics?
4 million Americans get a routine pneumonia each year, so it’s a pertinent question.
“I couldn’t go outside a lot, and I couldn’t breathe in cold air.” He’s just in the seventh grade, but Ian Halusuczak developed pneumonia, an infection of the lung. When it is a bacterial pneumonia, as is often the case, the disease is treated with antibiotics. “I couldn’t go to school, so I had to stay at home for 2 weeks,” recalls Ian.
Ian is young and healthy, and so it was reasonable that he be treated at home. “I think that the fact that he was home was probably more comforting to him,” says Barbara, Ian’s mom.
But each year in the U.S., 600,000 of the four million patients with community acquired pneumonia are admitted to the hospital. And while experts agree that high risk patients need to be admitted, for those otherwise reasonably healthy individuals, the jury is still out on how to treat.
Since most patients under age 50, like Ian, are usually treated as outpatients and do well, a new study in the annals of internal medicine looked at those over 50. It found overall that patients treated outside the hospital did just as well. In fact, more outpatients were satisfied with their overall care.
In the end, treating these individuals as outpatients can help reduce the 23 billion dollars spent on inpatient pneumonia care each year.
Dr. Michael Iannuzzi, Chief of Pulmonary Care and Sleep Medicine at Mt. Sinai Medical Center, says, “The big issue is if they have underlying diseases. If someone has a very high fever, 104, if their respiratory rate is fast, if their pulse rate is fast, more than 125, if their blood pressure is low, these are all reason to admit someone for pneumonia.”
Even many of those over the age of 70 did well as outpatients.
And fewer outpatients developed complications like blood clots in the legs or lungs. “So because it cost about $8000 to take care of a patient admitted into the hospital with pneumonia, and about $250 to take care of someone at home, we’d like to try to find a way to manage patients or identify patients who can be treated at home, and not be admitted to the hospital,” says Dr. Iannuzzi.
Around 80% of the pneumonia patients in both groups improved without side effects, complications, or the need to change antibiotics.
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