How Can I Manage Chronic Lung Infections
There is a three-pronged approach to treatment:
- Treatment to eradicate the infectious organism
- Treatment of the respiratory compromise
- Prevention strategies
Based on cultures, the frequent causes of pneumonia and other chronic lung infections can be identified. They can be tested against an assortment of antibiotics for those to which they prove the most sensitive. Unusual bacteria, such as the anaerobic bacteria, will require specific, more potent antibiotics due to their increased virulence and resistances; the Mycobacteria of tuberculosis will require therapy with antitubercular agents for at least 4 months. Fungal infections are treated with antifungal agents.
Viral infections of the lung which fail to resolve are typically due to immunocompromise, so treatment will involve both antiviral agents and reduction of any immunosuppression. Since immunosuppression is the key feature to treating HIV, autoimmune disease, and transplant patients, this must be weighed seriously according to risk-vs-benefit.
By the nature of chronic lung infections, the length of therapy will be longer than what is implemented in common pneumonias and other lung infections.
Persistent treatment failure should prompt investigations to rule out sequestered sites of occult infection in the lungs as a source of continuous re-seeding of infection, such as lung abscesses or empyema.
Treatment of Pulmonary Compromise
The pulmonary compromise of gas exchange between carbon dioxide and oxygen is already significant in comorbidities that make chronic lung infections more likely. The further inflammatory and exudative effects of infection only worsen this. Bronchodilators, mucolytic medication, and assisted ventilation with supplemental oxygen are used to maintain respiratory function until the difficulties are mitigated by successful antimicrobial eradication.