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Diagnosed with left basal pneumonia. Having constant pain in lung when breathing. How long will it take to get cured?

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Practicing since : 2009
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I have just been diagnosed with Left Basal Pneumonia and I have had a chest xray, I am on my 2nd lot of antibiotics - Clarithromycin 500mg twice a day for 7 days but I have been taking this for over 48 hours after the 5 day course of Amoxicillin (250mg 3 times daily for 5 days), I am constantly in pain in my lungs when i breathe and cough, I have been told to go back to my doctors in 48 hours to be rechecked over to see if i still have the crackling in my lung, how long can this go on for and am I likely to be admitted into hospital?
Posted Mon, 8 Oct 2012 in Lung and Chest disorders
Answered by Dr. Arnab Maji 3 hours later

Thanks for your query.

Your pain in the lung during breathing and coughing is due to pleurisy which is caused by pneumonia. You are symptomatically not improved even after 5 days course of amoxicillin and you are rightly started with clarithromycin tablets. Usually with successful antibiotic treatment clinical improvement starts on the 3rd day onwards i.e. after 48 hours though radiological clearing os shadows may take 3-4 weeks for complete clearing. So your physician rightly told you to go to him for rechecking your improvement. If no clinical improvement is there he may add some other antibiotics or change it.

Ideally you before the start of antibiotic treatment should have a sputum examination with culture-sensitivity testing because incidence of drug resistance is very high now and incidence of pneumonia due to atypical organisms. Though you can have sputum examination now but there is very low chance of getting any organism now because you have already taken 2 antibiotics now. But, I think you should have one sputum examination now specially for AFB (acid fast bacilli) staining and fungal smear and staining because antibiotics will not interfere their growth. A routine hemogram and blood culture is also needed to be done.

Decision of admission in the hospital depends upon many factors like –
1.     Your mental status and general well being,
2.     Serum urea, creatinine level,
3.     Your age (>65 years – not applicable for you), presence of co-morbidities like diabetes,
4.     Vitals like pulse, blood pressure, respiratory rate
If your physician found any abnormality in the above parameters he can admit you. Otherwise he should not.

It is very difficult to say how long your illness will go on. But usually in uncomplicated cases it usually takes 10 days to clear up. But if proper treatment in the form of proper antibiotic selection is not done then it may take much longer time. But your physician on empirical basis has started right antibiotics. You have to wait with patience for few more days to have an idea on outcome.

Hope I have answered your queries. If you have further queries you may ask me freely. Kindly write a review on this answer.

Wish you quick recovery.

Dr Arnab Maji

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