Bacterial Pneumonia Symptoms, Treatment, and Prevention

Pneumonia is a respiratory infection that primarily affects the small air sacs (alveoli) and interstitial tissue of the lungs. No infection claims more lives in industrialised nations than pneumonia. According to WHO, pneumonia is the leading infectious cause of death in children under five years old worldwide.([FOOTNOTE=Walker CL et al. Global burden of childhood pneumonia and diarrhoea. The Lancet. 2013; 381(9875), 1405–1416.],[ANCHOR=],[LINK=])

The most common symptoms of pneumonia are:

• Cough
• Difficulty breathing
• Rapid heartbeat
• Fever
• Sweating and shivering
• Loss of appetite
• Chest pain

The diagnosis of pneumonia is complicated, as its symptoms can be both typical and atypical, and as such, can often seem to conflict with one another. Typical pneumonia can present very suddently, often with fever and a productive cough. On auscultation, crackling sounds may be audible. Atypical pneumonia, on the other hand, presents with the gradual onset of an unproductive cough, shortness of breath, and a variety of non-lung symptoms. Auscultation may not indicate any issue. In reality, some patients may present both typical and atypical symptoms. There is a broad spectrum of pathogens associated with both typical and atypical pneumonia.

Both community-acquired and hospital-acquired pneumonia are major causes of death in the developed world.([FOOTNOTE=Steel H, Cockeran R, Anderson R, et al. Overview of community-acquired pneumonia and the role of inflammatory mechanisms in the immunopathogenesis of severe pneumococcal disease. Mediators Inflamm. 2013: 490346.],[ANCHOR=],[LINK=])^,([FOOTNOTE=Montravers P, Harpan A, Guivarch E, et al. Current and future considerations for the treatment of hospital-acquired pneumonia. 2016. Adv Ther;33(2):151-66.],[ANCHOR=],[LINK=])

According to a report by the National Institute for Health and Care Excellence (NICE) every year, a total of 0.5%-1% of adults in the UK will be diagnosed with community-acquired pneumonia.([FOOTNOTE=National Institute for Health and Care Excellence. Pneumonia in adults: diagnosis and management. 2014.],[ANCHOR=],[LINK=]) In addition, community-acquired pneumonia is diagnosed in 5–12% of adults who present to GPs with symptoms of lower respiratory tract infection, and subsequently, 22–42% of these individuals are admitted to hospital, with the mortality rate of 5-14%.⁵ Moreover, between 1.2% and 10% of adults admitted to hospital with community-acquired pneumonia are managed in an intensive care unit, with the risk of mortality greater than 30%.⁵ More than half of pneumonia-related deaths occur in people older than 84 years.⁵

Further, NICE reports that around 1.5% of hospital inpatients in England will have a hospital-acquired respiratory infection at any given time, where hospital-acquired pneumonia (HAP) will account for more than half of these infections.⁵ It has been demonstrated that hospital-acquired pneumonia can increase the average hospital stay by around 8 days, with reported mortality of from 30-70%.⁵