- Author: Denise Serebrisky, MD; Chief Editor: Michael R Bye, MD more...
Intravenous antibiotics should be directed against the most likely bacterial pathogens, including S aureus and S pneumoniae. Other considerations should include antibiotic coverage for K pneumoniae,E coli, and group A streptococci. Most often, an appropriate single agent can be used, but combined antibiotic therapy can be considered, especially if a specific organism is not identified. As community-associated methicillin-resistant S aureus (MRSA) has increasingly been identified, reconsideration of empiric choice of antistaph beta-lactam for seriously ill patients with suspected MRSA should be carefully considered. The following antimicrobials may be used to target an underlying pneumonia.
A very effective antibiotic for treating S aureus as well as S pneumoniae.
Drug combination of beta-lactamase inhibitor with ampicillin. A very effective antibiotic for treating S aureus as well as S pneumoniae. Also effective for many anaerobic infections.
Very effective antibiotic for treating S aureus and S pneumoniae.
Very effective antibiotic for treating methicillin-resistant S aureus as well as for treating penicillin-resistant S pneumoniae.
To avoid toxicity, current recommendation is to assay vancomycin trough levels before fourth dose. Use CrCl to adjust dose in patients with renal impairment.
Very effective antibiotic for treating S aureus as well as S pneumoniae. Lincosamide for treatment of serious skin and soft tissue staphylococcal infections. Also effective against aerobic and anaerobic streptococci (except enterococci). Inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest.
Very effective antibiotic for treating S aureus as well as S pneumoniae. A fluoroquinolone with activity against Pseudomonas, streptococci, MRSA, S epidermidis, and most gram-negative organisms but no activity against anaerobes. Inhibits bacterial DNA synthesis and consequently growth.
Hussain N, Noce T, Sharma P, Jagjivan B, Hegde P, Pappagallo M, et al. Pneumatoceles in preterm infants-incidence and outcome in the post-surfactant era. J Perinatol. 2010 May. 30(5):330-6. [Medline].
Arora P, Kalra VK, Natarajan G. Pneumatoceles in infants in the neonatal intensive care unit: clinical characteristics and outcomes. Am J Perinatol. 2013 Sep. 30(8):689-94. [Medline].
Van Hoorebeke E, Jorens PG, Wojciechowski M, Salgado R, Desager K, Van Schil P, et al. An unusual case of traumatic pneumatocele in a nine-year-old girl: a bronchial tear with clear bronchial laceration. Pediatr Pulmonol. 2009 Aug. 44(8):826-8. [Medline].
Imamoglu M, Cay A, Kosucu P, et al. Pneumatoceles in postpneumonic empyema: an algorithmic approach. J Pediatr Surg. 2005 Jul. 40(7):1111-7. [Medline].
Carrey J. On the natural regression of pulmonary cysts during early infancy. Pediatr. 1953. 11:48-64.
Conway DJ. The origin of lung cysts in childhood. Arch Dis Child. 1951. 26:504-529.
Boisset GF. Subpleural emphysema complicating staphylococcal and other pneumonias. J Pediatr. 1972 Aug. 81(2):259-66. [Medline].
Galea MH, Williams N, Mayell MJ. Traumatic pneumatocele. J Pediatr Surg. 1992 Dec. 27(12):1523-4. [Medline].
Amitai I, Mogle P, Godfrey S, Aviad I. Pneumatocele in infants and children. Report of 12 cases. Clin Pediatr (Phila). 1983 Jun. 22(6):420-2. [Medline].
Kunyoshi V, Cataneo DC, Cataneo AJ. Complicated pneumonias with empyema and/or pneumatocele in children. Pediatr Surg Int. 2006 Feb. 22(2):186-90. [Medline].
Shamberger RC, Wohl ME, Perez-Atayde A, Hendren WH. Pneumatocele complicating hyperimmunoglobulin E syndrome (Job's Syndrome). Ann Thorac Surg. 1992 Dec. 54(6):1206-8. [Medline].
Schimke LF, Sawalle-Belohradsky J, Roesler J, Wollenberg A, Rack A, Borte M, et al. Diagnostic approach to the hyper-IgE syndromes: immunologic and clinical key findings to differentiate hyper-IgE syndromes from atopic dermatitis. J Allergy Clin Immunol. 2010 Sep. 126(3):611-7.e1. [Medline].
Hussain N, Noce T, Sharma P, Jagjivan B, Hegde P, Pappagallo M, et al. Pneumatoceles in preterm infants-incidence and outcome in the post-surfactant era. J Perinatol. 2009 Oct 8. [Medline].
Zuhdi MK, Spear RM, Worthen HM, Peterson BM. Percutaneous catheter drainage of tension pneumatocele, secondarily infected pneumatocele, and lung abscess in children. Crit Care Med. 1996 Feb. 24(2):330-3. [Medline].
Park TH, Kim JK. Nonsurgical management of an enlarging pneumatocele by fibrin sealant injection via pigtail catheter. Pediatr Pulmonol. 2016 Feb. 51 (2):E5-7. [Medline].
Fujii AM, Moulton S. VATS management of an enlarging multicystic pneumatocele. J Perinatol. 2008 Jun. 28(6):445-7. [Medline].
Levison ME, Fung S. Community-associated methicillin-resistant Staphylococcus aureus: reconsideration of therapeutic options. Curr Infect Dis Rep. 2006 Jan. 8(1):23-30. [Medline].
Asmar BI, Thirumoorthi MC, Dajani AS. Pneumococcal pneumonia with pneumatocele formation. Am J Dis Child. 1978 Nov. 132(11):1091-3. [Medline].
Chartrand SA, McCracken GH Jr. Staphylococcal pneumonia in infants and children. Pediatr Infect Dis. 1982 Jan-Feb. 1(1):19-23. [Medline].
Chitayat D, Diamant S, Lazevnick R, Spirer Z. Haemophilus influenzae type B pneumonia with pneumatocele formation. Clin Pediatr (Phila). 1980 Feb. 19(2):151-2. [Medline].
Hendren WH, Haggerty RJ. Staphylococcal pneumonia in infancy and childhood: Analysis of 75 cases. JAMA. 1958. 168:6-16.
Joosten KF, Hazelzet JA, Tiddens HA, et al. Staphylococcal pneumonia in childhood: will early surgical intervention lower mortality?. Pediatr Pulmonol. 1995 Aug. 20(2):83-8. [Medline].
Khan EA, Wafelman LS, Garcia-Prats JA, Taber LH. Serratia marcescens pneumonia, empyema and pneumatocele in a preterm neonate. Pediatr Infect Dis J. 1997 Oct. 16(10):1003-5. [Medline].
Knight GJ, Carman PG. Primary staphylococcal pneumonia in childhood: a review of 69 cases. J Paediatr Child Health. 1992 Dec. 28(6):447-50. [Medline].
McGarry T, Giosa R, Rohman M, Huang CT. Pneumatocele formation in adult pneumonia. Chest. 1987 Oct. 92(4):717-20. [Medline].
Quigley MJ, Fraser RS. Pulmonary pneumatocele: pathology and pathogenesis. AJR Am J Roentgenol. 1988 Jun. 150(6):1275-7. [Medline].
Schimpl G, Schneider U. Traumatic pneumatoceles in an infant: case report and review of the literature. Eur J Pediatr Surg. 1996 Apr. 6(2):104-6. [Medline].
Victoria MS, Steiner P, Rao M. Persistent postpneumonic pneumatoceles in children. Chest. 1981 Mar. 79(3):359-61. [Medline].
Al-Ghafri M, Al-Hanshi S, Al-Ismaily S. Two Cases of Pneumatoceles in Mechanically Ventilated Infants. Oman Med J. 2015 Jul. 30 (4):299-302. [Medline].