Can azithromycin treat all pneumonia?

Since the beginning of winter, patients with Mycoplasma pneumonia have appeared in many places, mainly children. As one of the treatment drugs, azithromycin has received a lot of attention. In recent years, azithromycin seems to have a high "appearance rate" . So, can all colds, fevers and pneumonia be treated with azithromycin?

Azithromycin belongs to the macrolide class of drugs , which are often used clinically as the first choice for infections caused by aerobic G (Gram-positive) bacteria, G- (Gram-negative) cocci, and anaerobic cocci. They also have good effects on infections caused by Legionella pneumophila, Campylobacter, Mycoplasma, Chlamydia, Toxoplasma, atypical mycobacteria , etc.

Therefore, not all pneumonia can be treated with azithromycin, and azithromycin is not only used to treat Mycoplasma pneumonia .

The "Guidelines for the Diagnosis and Treatment of Mycoplasma Pneumonia in Children (2023 Edition)" points out that there are three main types of antimicrobial drugs for the treatment of Mycoplasma pneumonia: macrolides, new tetracyclines, and quinolones . Macrolides include azithromycin, clarithromycin, erythromycin, roxithromycin, and acetylkitasamycin . When prescribing macrolides, doctors should consider the effectiveness and safety of these three types of drugs and the child's condition.

Do families need to stock up on antibiotics?

Many people keep some antibacterial drugs at home in case of emergency. In fact, I don’t recommend that you do this.

The common cold is usually caused by a viral infection, while antibiotics target bacterial and fungal infections and are ineffective against viral infections. On the other hand, there are many types of pathogens, the most important of which are bacteria, fungi, viruses, etc. Antimicrobial drugs are also divided into more than a dozen categories based on their mechanism of action, and are further subdivided according to the different groups in their chemical structure. Different types of bacteria have different sensitivities to antibiotics, and even the same type of antibiotics have certain differences in their antibacterial spectra.

For example, the well-known cephalosporins can be clinically divided into five generations according to their characteristics. Each generation of cephalosporins has many representative drugs, and their focus is different in fighting bacteria.

Due to lack of professional knowledge, patients often cannot accurately judge whether they really need to use antibiotics, nor can they choose antibiotics according to their symptoms. Taking medicine on their own may delay treatment and aggravate the condition. Using the wrong medicine may even harm their health. On the other hand, insufficient course of treatment or insufficient dosage of antibiotics may also cause bacterial resistance. Therefore, it is not wise to stockpile antibiotics at home.

Misunderstandings about antimicrobial drugs

1. Stop taking the medicine as soon as the symptoms improve

Antimicrobial drugs have a certain course of treatment for infection. Some patients ask to stop taking the drugs immediately when they feel their symptoms have improved, or stop taking the drugs without authorization, thinking that taking more will have side effects and be harmful to the body. In fact, the antibacterial efficacy of antibiotics is mainly related to the duration of drug concentration within a certain range . When the symptoms of infection have just improved, the pathogenic bacteria in the human body have not been completely killed. If the drug is stopped too early, it will lead to repeated infections, and bacteria will easily develop drug resistance , and the patient's symptoms will worsen. Therefore, it is necessary to take the drug according to the course of treatment.

2. The more expensive the drug, the better

Many patients "only choose the expensive ones, not the right ones", believing that the more expensive the antibiotics, the better the treatment effect. In fact, when doctors choose antibiotics, they will choose antibiotics and formulate medication plans based on many factors such as the patient's symptoms, signs, radiology, ultrasound and other imaging results, and drug sensitivity test results, rather than based on the price of the drugs.

3. Antibacterial drugs are anti-inflammatory drugs

Antimicrobial drugs are not the same as anti-inflammatory drugs . Inflammation can be divided into infectious inflammation and non-infectious inflammation in medicine. Infectious inflammation is caused by pathogenic microorganisms (mostly bacteria or fungi) infecting the body, and this type of infection requires treatment with antibiotics. Non-infectious inflammation is caused by non-infectious factors such as antigen stimulation, non-invasive trauma, and autoimmunity, such as redness, swelling, heat, and pain after a joint sprain or rheumatoid arthritis. This type of inflammation requires the use of anti-inflammatory and analgesic drugs such as aspirin and ibuprofen.

4. Infusion is more effective than medication

Many patients actively ask for intravenous infusion when they seek medical treatment. This practice is wrong. Doctors will weigh the pros and cons and choose oral or intravenous administration based on the patient's infection, the severity of the disease and the characteristics of the antibiotics. For example, the bioavailability of oral quinolone dosage forms can reach more than 90%, which is almost the same as the effect of infusion. For bacterial diarrhea or simple urinary tract infection, oral antibiotics can achieve a bactericidal effect. Oral antibiotics are more convenient and safer. The principle of rational drug use determined by the World Health Organization is " do not inject intramuscularly if you can take it orally, and never inject intramuscularly if you can inject it intramuscularly ."