Bacterial Pneumonia in People With COPD

What Every COPD Patient Needs to Know About Bacterial Pneumonia

An elderly caucasain gentleman visits and prays over his wife as she tries to recover from an illness
Photodisc/Getty Images

Bacterial pneumonia and chronic obstructive pulmonary disease is a common, but dangerous combination. It is estimated that more than 3 million cases of bacterial pneumonia occur each year in the United States alone. When treated, it is highly curable. If left untreated, however, it has a mortality rate of about 30 percent.

Pneumonia and COPD

In patients who are diagnosed with a lung disease like chronic obstructive pulmonary disease (COPD), contracting bacterial pneumonia can cause a downward spiral of repeated lung infections and a further decline of lung function.

COPD not only raises the risk, but even some of the treatments you may use, such as inhaled steroids, may increase the risk further. So, why does bacterial pneumonia take such a toll on people who have COPD? Let's take a look.

Causes of Bacterial Pneumonia

Pneumonia caused by Streptococcus pneumoniae is the most common form of bacterial pneumonia.

In most cases, bacteria from the upper airways finds its way into the lungs. Once there, the infection is influenced by a number of factors - the overall health of the patient, the status of the patient's immune system and the virulence (toxicity) of the bacteria.

If a patient has a weak immune system, such as someone with a chronic disease like COPD, they are at greater risk for developing bacterial pneumonia because they lack the necessary defense mechanisms to protect themselves.  In addition to having your immune defenses under the weather with COPD, that ability to clear secretions is decreased.

  This can cause a spiral that is best prevented or at least caught early.

Signs and Symptoms of Bacterial Pneumonia

What symptoms should you be aware of, that suggest you could be coming down with bacterial pneumonia?  Symptoms and signs may include:

  • Sudden onset of chills
  • Rapidly rising fever - 101 to 105 degrees Fahrenheit
  • Stabbing chest pain aggravated by breathing and coughing
  • Rapid, shallow breathing (tachypnea) - 25 to 45 breaths per minute
  • Respiratory grunting (grunting sounds made during breathing)
  • Nasal flaring
  • Use of accessory muscles for breathing (muscles other than the diaphragm and intercostals (muscles between the ribs).

Diagnosing Bacterial Pneumonia

The following tests may be ordered by your doctor to help her determine the presence of bacterial pneumonia:

Treatment of Bacterial Pneumonia

The gold standard of treatment for bacterial pneumonia is antibiotic therapy. Common antibiotics used to treat bacterial pneumonia include:

  • Avelox
  • Zithromax
  • Erythromycin
  • Augmentin
  • Vancomycin
  • Rochephin
  • Levaquin
  • Ceftazidime
  • Zyvox

Prevention of Bacterial Pneumonia

An ounce of prevention being better than a pound of cure was never more accurate than with pneumonia and COPD.

  Do you know how to really wash your hands?  Studies tell us the vast majority of people don't use proper handwashing technique - at least the kind of handwashing that gets rid of the kind of germs which cause bacterial pneumonia.  Quitting smoking goes without saying, as we know that smoking both increases the risk of pneumonia, and makes it harder to recover once you have it.

If you've had your pneumonia vaccine, that's a great step in the right direction, but make sure you got the right shot.  The PPSV pneumonia vaccine is recommended for those at high risk, such as anyone with COPD.  And the flu shot is a must.  The flu virus is a virus, not a bacterium, but that doesn't make it less of a problem.  The flu has a nasty tendency to create the perfect set up for a bacterial infection to move in a cause an uproar.  It's still fairly new so we don't have a lot of data, but the high dose flu shot that's recommended for people over the age of 65 may be the best choice.  The flu-mist nasal spray, in contrast, may not be the best choice.  It's not recommended for people with cancer due to the immune system not functioning well, but COPD can cause the immune system to function poorly as well.

Prognosis of Bacterial Pneumonia

While the prognosis of bacterial pneumonia is generally good in otherwise healthy patients, the following factors, alone, or in combination, can increase morbidity (sickness rate) and mortality (death rate.)

If you have been diagnosed with bacterial pneumonia during an inpatient hospital admission, it is recommended that you follow-up with a chest X-ray about six weeks after your discharge from the hospital.

Sources:

Diao, W., Shen, N., Yu, P., Liu, B., and B. He. Efficacy of 23-valent pneumococcal polysaccharide vaccine in preventing community-acquired pneumoniaamong immunocompetent adults: A systematic review and meta-analysis of randomized trials. Vaccine. 2016. 34(13):1496-1503.

Iannella, H., Luna, C., and G. Waterer. Inhaled corticosteroids and the increased risk of pneumonia: what's new? A 2015 updated review. Therapeutic Advances in Respiratory Disease. 2016 Feb 18. (Epub ahead of print).

Torres, A., Blasi, F., Dartois, N., and M. Akova. Which individuals are at increased risk of pneumococcal disease and why? Impact of COPD, asthma, smoking, diabetes, and/or chronic heart disease on community-acquired pneumonia and invasive pneumococcal disease. Thorax. 2015. 70(10):984-9.

Continue Reading