STATISTICS OF PNEUMONIA IN THE PHILIPPINES

According to the Department of Health (DOH), in 2009, there are 690,566

cases of pneumonia per 100,000 in a 5-year average (2003-2008) and because of
this it ranks 1st in the cause of morbidity, while there are 32, 989 cases per 100,000
in a 5-year average (2003-2008) and it ranks 4th as the leading causes of mortality.

In 2008, Pneumonia in Antipolo City ranks 4th cause of morbidity with a

number of 10, 359 per 100,000 population, while in mortality it ranks 3 rd cause of
mortality with a number of 983 per 100,000 population.

ETIOLOGIC AGENTS

Community-acquired pneumonia develops in people with limited or no

contact with medical institutions or settings. The most commonly identified
pathogens are Streptococcus pneumoniae, Haemophilusinfluenzae, and atypical
organisms (ie, Chlamydia pneumoniae, Mycoplasma pneumoniae)

Many organisms cause community-acquired pneumonia, including bacteria,

viruses, and fungi. Pathogens vary by patient age and other factors (see Table
1: Pneumonia: Community-Acquired Pneumonia in Children andTable
2: Pneumonia: Community-Acquired Pneumonia in Adults ), but the relative
importance of each as a cause of community-acquired pneumonia is uncertain,
because most patients do not undergo thorough testing, and because even with
testing, specific agents are identified in< 50% of cases.

S. pneumoniae, H. influenzae, C. pneumoniae, and M. pneumoniae are the

most common bacterial causes. Pneumonia caused by chlamydia and mycoplasma
are often clinically indistinguishable from pneumonias with other causes.

C. pneumoniae accounts for 2 to 5% of community-acquired pneumonia and

is the 2nd most common cause of lung infections in healthy people aged 5 to 35
yr. C. pneumoniaeis commonly responsible for outbreaks of respiratory infection
within families, in college dormitories, and in military training camps
Common fungal pathogens include Histoplasmacapsulatum (histoplasmosis)
andCoccidioidesimmitis (coccidioidomycosis).Pneumocystis jiroveci commonly
causes pneumonia in patients who have HIV infection or are immunosuppressed.

Table 1: Etiological Agents of Community Acquired Pneumonia in Children

Age Organism

Birth to 3weeks Group B streptococci, listeria

monocytogenes, gram-negative bacilli,
cytomegalovirus

3weeks to 3 months Streptococcus pneumoniae viruses,

parainfluenzae, Bordetella pertussis,
staphylococcus aureus, Chlamydia
trachomatis (Transnatal exposure)

4 months to 4 years S. pneumoniae, mycoplasma

pneumoniae (In older children), Group A
streptococci

5 years to15 yrs S. pneumoniae, M. pneumoniae,

Chlamydia pneumoniae

Table 2: Community acquired Pneumonia in Adults

Age Organisms

I. Outpatients-no modifying factors Streptococcus pneumoniae, Mycoplasma

present pneumoniae, Chlamydia pneumoniae,
Haemophilusinfluenza

II. Outpatient-modifying factors S. pneumoniae, including drug resistant

present forms; M pneumoniae; C. pneumoniae;
mixedinfection (bacteria + atypical
pathogen or virus); H. influenzae; enteric
gram-negativeorganisms; respiratory
 viruses;miscellaneous (Moraxella

catarrhalis, Legionella sp,anaerobes

[aspiration], M. tuberculosis, endemic
fungi)

III. In patient-not in ICU S. pneumoniae, H. influenzae;

M.pneumoniae; C. pneumonia; mixed
infection (bacteria + atypical pathogen
or virus); respiratory viruses; Legionella
sp, miscellaneous (M.
tuberculosis,endemic fungi,
Pneumocystis jiroveci)

IV A. ICU patient-no pseudomonas S. pneumoniae, including drugresistant

risk factors forms, Legionella sp, H. influenzae,
enteric gram-negative organisms, S.
aureus, M.

pneumoniae, respiratory
viruses,miscellaneous (C. pneumoniae,M.
tuberculosis, endemic fungi)

IV B. ICU patient-Pseudomonas risk Same as previous plusPseudomonas sp

factor present

*These guidelines do not apply to patients with immunosuppression, influenza,

aspiration pneumonia, or healthcare-associated pneumonia.

Modifying factors:
• Increased risk of drug-resistant organisms: Age > 65, alcoholism, antibiotic
within 3 months ofexposure to child in day care center, multiple coexisting
illnesses.
• Increased risk of enteric gram-negative organisms: Antibiotic use within 3
mo, cardiopulmonary disease (including COPD and heart failure), multiple
coexisting illnesses.
 • Increased risk of Pseudomonas aeruginosa: Broad spectrum antibiotics > 7
days in pastmonth, corticosteroid use, undernutrition, structural pulmonary
disease.

What Are the Signs and Symptoms of Pneumonia?

The symptoms of pneumonia vary from mild to severe. Many factors affect how
serious pneumonia is, including the type of germ causing the infection and your age
and overall health

Symptoms of CAP commonly include:

• problems breathing
• coughing that produces greenish or yellow sputum
• a high fever that may be accompanied with sweating, chills,
and uncontrollable shaking
• sharp or stabbing chest pain
• rapid, shallow breathing that is often painful

Less common symptoms include:

• the coughing up of blood (hemoptysis)

• headaches (including migraine headaches)
• loss of appetite
• excessive fatigue
• blueness of the skin (cyanosis)
• nausea
• vomiting
• diarrhea
• joint pain (arthralgia)
• muscle aches (myalgia)

The manifestations of pneumonia, like those for many conditions, might not be
typical in older people. They might instead experience:

• new or worsening confusion

• hypothermia

Complications of Pneumonia

Often, people who have pneumonia can be treated successfully and not have
complications. But some patients, especially those in high-risk groups, may have
complications such as:
 • Bacteremia (bak-ter-E-me-ah). This serious complication occurs when the
infection moves into your bloodstream. From there, it can quickly spread to
other organs, including your brain.
• Lung abscess. An abscess occurs when pus forms in a cavity in the lung. An
abscess usually is treated with antibiotics. In some cases, surgery or needle
drainage is needed to remove it.
• Pleural effusion. Pneumonia may cause fluid to build up in the pleural
space, which is the space between your lungs and chest wall. Pneumonia can
cause the fluid to become infected—a condition called empyema (em-pi-E-
ma). If this happens, you may need to have the fluid drained through a chest
tube or removed through surgery.

TREATMENT FOR PNEUMONIA

Pharmacological Treatment

Pneumonia treatments vary, depending on the severity of your symptoms and the
type of pneumonia you have.

• Bacterial. Doctors usually treat bacterial pneumonia with antibiotics.

Although you may start to feel better shortly after beginning your medication,
be sure to complete the entire course of antibiotics. Stopping medication too
soon may cause your pneumonia to return. It also helps create strains of
bacteria that are resistant to antibiotics.

• Viral. Antibiotics aren't effective against most viral forms of pneumonia. And
although a few viral pneumonias may be treated with antiviral medications,
the recommended treatment generally is rest and plenty of fluids.

• Mycoplasma. Mycoplasma pneumonias are treated with antibiotics. Even so,

recovery may not be immediate. In some
after the infection itself has cleared. Many
go undiagnosed and untreated. The signs
bad chest cold, so some people never seek
generally go away on their own.
cases fatigue may continue long
cases of mycoplasma pneumonia
and symptoms mimic those of a
medical attention. The symptoms

• Fungal. If your pneumonia is caused by a fungus, you'll likely be treated with

antifungal medication.
Listed below are some of the medication given to a patient with Pneumonia.

 Azithromycin 500mg once daily or

 Clarithromycin 500mg twice daily

 Levofloxacin 500mg once daily

 Augmentin 875mg orally twice daily

Home Remedies

• One should go for raw juices for 5-7 days for initial days. For this one can take
glass of fruit or vegetable juice diluted with warm water on 50-50 basis. This
is to be taken every two hourly. Fruits like oranges, pineapple, apple, lemon
etc are beneficial.

• Avoid strong tea, coffee and other stimulant beverages. This may produce
bad effect in pneumonia.

• One should also avoid white sugar, white flour and all products made out of
them. These are heavy to digest and may worsen the case of pneumonia

• Meats and alcoholic beverages are not allowed in any condition

• Massage turpentine oil or vicks on the patient’s ribs and wrap warm cotton
wool. It will help in reducing the pain of Pneumonia. This is one of the
effective home remedies for pneumonia

• Smoking works as poison in case of pneumonia. It gives lots of trouble to

lungs and puts extra burden to get right oxygen levels.

• During acute and early stage of pneumonia, the herbal tea having black
pepper will be beneficial.

• Ginger and black pepper are mucolytic enhancer are considered to be good
for expelling mucus from the body especially from the respiratory tract. Take
these herbs in cooked form and it will be better for your lungs.

• Simple luke warm water with lemon juice and pinch of rock salt will give
temporary relief in coughing and congestion during the pneumonia attack.
This is on e of the best home remedies for pneumonia.

• Sesame seeds are one of the favorable natural remedy for pneumonia. Take
250 ml of water and put 15 gm of sesame seeds. Add pinch of common and 1
tbsp of linseeds and one big tbsp of honey. Mix it well and take it daily. This
will help removing the excess mucous from the bronchial tree.