Pneumonia is a serious respiratory infection that affects people of all ages, including teenagers. It can be brought on by bacteria, viruses, or fungi, with bacterial pneumonia being one of the more prevalent and curable types. It is important to have an early diagnosis and suitable antibiotic treatment in order to promote healing and avoid complications of pneumonia in teenagers. The medications, vaccinations, diagnostic procedures, and preventative measures associated with bacterial pneumonia in teenagers are discussed in this article.

Understanding pneumonia

In general, pneumonia is classified into four different groups:¹

• Community-acquired pneumonia
• Hospital-acquired pneumonia
• Healthcare-acquired pneumonia
• Aspiration pneumonia

Community-acquired pneumonia

The most common type of pneumonia is community-acquired pneumonia, which refers to infections contracted outside of hospitals or other healthcare facilities. The causes of pneumonia can include bacteria, bacteria-like organisms, fungi, and viruses, including SARS-CoV-2 virus.¹ 

Hospital-acquired pneumonia

The second type is hospital-acquired pneumonia, which develops during your hospital stay for another illness or procedure. This form of pneumonia is typically caused by bacteria found in the hospital environment.¹

Healthcare-acquired pneumonia

The third type is healthcare-acquired pneumonia, which occurs in people who have spent time in long-term facilities, outpatient clinics, and kidney dialysis centres. In these cases, the infections are often caused by bacteria that are more resistant to antibiotics.¹

Aspiration pneumonia

Aspiration pneumonia results from inhaling substances such as food, liquid, or vomit into the lungs due to a weakened gag reflex.¹ The gag reflex, also called the pharyngeal reflex, is an automatic reaction that helps protect the airway by contracting the pharyngeal muscles and elevating the soft palate.²

Community-acquired Pneumonia (CAP) Versus Healthcare-associated Pneumonia (HCAP)

Pseudomonas aeruginosa and Acinetobacter baumannii are among the most frequently isolated microorganisms in HCAP, whereas Streptococcus pneumoniae and Haemophilus influenzae are the most frequent pathogens in CAP. HCAP patients are more likely to receive inappropriate empirical antibiotic therapy, while CAP patients generally receive adequate antibiotic treatment. HCAP patients are associated with a higher mortality rate and longer hospital stays compared to CAP patients. Since HCAP varies from CAP in terms of the patient's characteristics, the causative bacterium, and the prognosis, all patients hospitalised with CAP should be examined for risk factors associated with HCAP to ensure appropriate therapy and improve outcomes. HCAP often involves potentially drug-resistant bacteria; therefore, it is essential to consider these pathogens when selecting empirical antibiotics for these patients.³

Symptoms

Symptoms of pneumonia include green or yellow mucus, called phlegm may be produced by a cough. A high temperature, respiratory problems, chest pain, a sore body, a sense of extreme weariness, loss of appetite, and wheezing noises may also occur. In infants, grunting may be present. In a geriatric patient (the term “geriatric” refers to people with more than 60 years of age), confusion can occur commonly.⁴

Adolescent pneumonia

Mycoplasma pneumoniae is recognised as the major cause of pneumonia in adolescents. Despite advances in antibiotic treatment and prevention, pneumonia, an acute infection of the pulmonary parenchyma, continues to have a substantial impact on adolescent health. Although the fatality rate is low, pneumonia is associated with high morbidity and significant costs to healthcare systems.⁵

Treatment of pneumonia

Selecting the correct treatment for pneumonia is of utmost importance. For instance, antibiotics should not be prescribed if pneumonia is caused by viruses rather than bacteria. Therefore, accurately distinguishing between viral and bacterial pneumonia is critical. Antimicrobial resistance (AMR) education is crucial to ensure the effectiveness of antibiotics in the future. 

Antibiotics for bacterial pneumonia

Most people with pneumonia require oral antibiotics, which are often given at a health facility. Low-cost oral antibiotics can also be used to treat various infections at the community level by trained community health workers. Hospitalisation is only recommended in cases of severe pneumonia.⁶ 

Amoxicillin and azithromycin are the two major antibiotics used to treat bacterial pneumonia. In addition to its traditional application, tigecycline is a novel antibiotic and the first glycylcycline of the tetracycline antibiotic class. It has a significant in vitro effect against the causative bacteria most frequently seen in individuals with community-acquired pneumonia.¹ In between 2 and 4 weeks, an enhancement in the general condition of the patient is observed in general occurrences, whereas if not provided due to the simple antibiotic treatment attitude, then the patient should seek further assistance for disease management and to recover from the disease.

Vaccination

There are two vaccinations available for pneumonia: Pneumovax23® and Prevnar13®. This section provides fundamental information regarding vaccination and important warning statements. Both vaccines protect against bacterial infections caused by pneumococcal bacteria. Although these vaccinations do not protect your body against all types of bacteria, they strengthen the body's general protection against infections.⁷ 

Regarding the Pneumovax23® vaccination, you should inform the healthcare professional responsible for your care about any of the following conditions:

• A bleeding disorder
• A history of bone marrow or organ transplantation
• A diagnosis of cancer or Hodgkin’s disease
• Current fever, infection, or immune system problems
• A low platelet count
• If you are breastfeeding, pregnant, or planning to become pregnant
• Any allergies, such as to diphtheria toxoid, latex, or dyes

Drug-pneumonia vaccine interaction

As a vaccine recipient, you should be aware of several potential interactions with other medications you may be taking. These drug-vaccine interactions can occur with chemotherapy medications, immunosuppressive drugs, steroid medicines such as prednisone and cortisone and lastly, medications that prevent blood agglutination such as enoxaparin and warfarin. Apart from pharmacological interventions, it is important to inform your healthcare provider about your alcohol consumption, smoking habits, over-the-counter (OTC) supplements and herbal products you use.⁷

Adverse events

After taking an active pharmaceutical ingredient (API), some adverse effects can occur. If your body temperature is equal to or greater than 102℉ (approximately 38.89℃), it is urgently recommended that you consult your healthcare professional. Other side effects include loss of appetite, respiratory system problems (such as breathing difficulty), a sense of confusion, act of tingling, seizures, etc. 

You should report any adverse effects you experience to your healthcare professional, and you may also choose to inform governmental regulatory agencies.^7,8 In the UK, any adverse reactions can be reported to the Medicines and Healthcare products Regulatory Agency (MHRA) through the Yellow Card Scheme. 

How to get protected from respiratory diseases

Smoking cessation can be recommended, as smoking is dangerous and it harms your lungs’ natural capability to defend themselves. You could boost your immune system by considering Sambucus nigra (elderberry) or zinc supplements after consulting your GP, pharmacist, or other healthcare professional. Maintaining sufficient sleep, engaging in regular exercise and physical activity, and practising good sanitation and personal hygiene are all essential. Vaccination also plays a crucial role in providing protection from respiratory diseases.⁶

Some post-treatment complications and risk factors

Some vulnerable groups are more prone to developing complications from pneumonia even after receiving appropriate therapy or medication. These patients may experience issues such as breathing difficulty, bacteremia, pleural effusion, and lung abscess. Additionally, some people are more likely to get pneumonia if they have been previously hospitalised, have chronic diseases such as chronic obstructive pulmonary disease (COPD), are smokers, or have problems with their immune system. For example, HIV/AIDS patients (who have immune system deficiencies) are at increased risk for developing pneumonia.⁶

Contagiousness of pneumonia disease

Pneumonia caused by bacteria is considered contagious. If you have bacterial pneumonia, you are no longer considered infectious once your fever has gone down and you have taken antibiotics for at least two days. However, if you have viral pneumonia, you are considered infectious until you recover and have been fever-free for a few days.⁷

Summary

Even though bacterial pneumonia is still a serious respiratory disease, recovery is possible with prompt diagnosis and appropriate antibiotic treatment. The recommended first-line antibiotic for treating pneumonia is amoxicillin dispersible tablets. Preventive measures can drastically lower the risk of disease. These include immunisations and lifestyle changes, including quitting smoking and practising basic hygiene. Moreover, patient safety and better management are ensured by being aware of possible medication interactions and post-treatment problems. The efficacy of these life-saving drugs must be maintained by ongoing public education on antibiotic stewardship and antimicrobial resistance.