💊 Rx Antibiotics para sa Pulmonya
Per PSMID 2020 PH Adult CAP CPG, ang treatment ay base sa risk stratification. Lahat ng nasa baba ay prescription-required. BAWAL ang self-medicate.
- Amoxicillin 500-1000 mg q8h x 5-7 days (Amoxil, generic): P4-10/cap. First-line para sa low-risk outpatient CAP. Strep pneumoniae coverage.
- Co-Amoxiclav 625 mg q12h o 1 g q12h x 7 days (Augmentin, Natravox): P35-55/tab. Para sa mid-risk o suspected resistant Strep.
- Azithromycin 500 mg OD x 3-5 days (Zithromax, Azimed, Zmax): P40-80/tab. First-line para sa atypical pneumonia (Mycoplasma, Chlamydia, walking pneumonia).
- Doxycycline 100 mg q12h x 7 days (Doxin, generic): P3-8/cap. Atypical coverage. Iwasan sa buntis at bata under 8.
- Levofloxacin 750 mg OD x 5 days (Levox, Cravit, Tavanic): P50-150/tab. Para sa first-line failure, comorbidities (DM, CHF, CKD), o moderate severity.
- Clarithromycin 500 mg q12h x 7-10 days (Klaricid, Klabax): P50-90/tab. Alternative macrolide.
🍬 Adjunct + Home Support
Antibiotic ang main treatment, pero ang sintomas (lagnat, plema, ubo) ay kailangan din ng supportive care para sa recovery.
- Carbocisteine 500 mg TID (Solmux, Loviscol): P5-12/cap. Mucolytic, pampaplema. Para mas madaling matanggal ang plema.
- Paracetamol 500 mg q4-6h PRN (Biogesic, RiteMed): P1-3/tab. Pampababa ng lagnat at pampawala ng pananakit.
- Salbutamol nebule 1 nebule q6h PRN: Para sa wheezing. Doctor-prescribed kung may bronchospasm.
- Maraming inumin: 8+ glasses tubig per day. Pampalambot ng plema at pampanatili ng hydration.
- Total bed rest 5-7 days: Tulungan ang katawan na lumaban sa infection. Avoid strenuous activity ng 2-4 weeks.
- Pulse oximeter check sa bahay: P500-1,500 home device. SpO2 <92% room air = ER agad.
CURB-65 Home Severity Check
Pwede mong i-self-check kung outpatient lang o kailangan ng confinement. 0-1 points = outpatient OK. 2 points = consider admission. 3+ points = inpatient/ICU.
| Criterion | Threshold | Score |
|---|---|---|
| C - Confusion | Bagong onset confusion o disoriented | +1 point |
| U - Urea (BUN) | BUN >7 mmol/L o 19 mg/dL (lab kailangan) | +1 point |
| R - Respiratory Rate | RR ≥30 per minute | +1 point |
| B - Blood Pressure | Systolic <90 o diastolic ≤60 | +1 point |
| 65 - Age | Edad 65 years old o pataas | +1 point |
Interpretation: 0-1 = mild, outpatient oral antibiotic OK. 2 = moderate, consider short hospitalization. 3-5 = severe, ICU consideration. Para sa walang BUN result, gamitin ang simplified CRB-65. Kung may DM, CHF, COPD, CKD = automatic upgrade sa severity.
Pneumonia Type → First-line Antibiotic
Bacterial CAP (typical)
Strep pneumoniae, H. influenzae. Fever, productive cough, lobar pattern. Amoxicillin o Co-Amox.
Atypical (walking pneumonia)
Mycoplasma, Chlamydia. Dry cough, low-grade fever, weeks. Azithromycin o Doxycycline.
Viral pneumonia
Influenza, COVID-19, RSV. Body aches, viral prodrome. Oseltamivir kung flu + supportive care.
Aspiration pneumonia
Anaerobes. Post-stroke, alcoholic, witnessed aspiration. Co-Amoxiclav o Clindamycin.
Hospital-acquired (HAP/VAP)
Pseudomonas, MRSA. Onset 48h+ after admission. Broad-spectrum IV (hospital).
TB pneumonia
M. tuberculosis. Weight loss, night sweats, >2 weeks. Refer Pulmonology + TB testing.
⏱️ Severity Guide
SpO2 >94%, RR <24, BP normal, alert, kaya kumain/uminom. Oral antibiotic 5-7 days at home. Follow-up sa 48-72 hrs.
Edad 65+, may comorbidities, SpO2 92-94%, mild hypoxia. Close monitoring. Outpatient pwede kung may caregiver support.
SpO2 <92%, RR >30, BP <90, confused, multilobar, cyanosis, hindi makahinga sa pahinga. IV antibiotic + oxygen.
Tips para sa Recovery + Prevention
Tapusin ang antibiotic course
Kahit gumaling na pakiramdam, ipagpatuloy ang 5-7 days. Maagang ititigil = relapse + antibiotic resistance.
Pulse oximeter sa bahay
P500-1,500 device. SpO2 monitoring 2-3x/day. <92% = ER agad. Lalo importante para sa elderly.
Full bed rest 5-7 days
Tulog ang #1 immune system support. Iwasan ang stress at strenuous activity. Slow return to work 2-4 weeks.
Pneumococcal vaccine sa 50+
PCV13/PCV20 + PPSV23 schedule. Prevents pneumococcal pneumonia. Free sa LGU vaccine programs.
Follow-up chest x-ray 6-8 weeks
Para sa 50+ years old o smokers. Rule out malignancy na napalitan na lang ng pneumonia. Mahalagang safety net.
PhilHealth coverage
Pulmonya ay covered case rate (P15,000-32,000 depending sa severity). I-tanong sa hospital billing kung in-network.
🚨 ER Agad Kung:
Mga Karaniwang Tanong
Ano ang pinaka-mabisang gamot sa pulmonya sa Pilipinas?
Walang OTC gamot sa pulmonya. Ang pulmonya ay dapat may doctor consult at Rx antibiotic. Sa karaniwang community-acquired pneumonia (CAP), first-line ay Amoxicillin 1000 mg q8h x 5-7 days (P4-10/cap) o Co-Amoxiclav 625 mg q12h (P35-55/tab). Para sa atypical o walking pneumonia, Azithromycin 500 mg OD x 3-5 days (P40-80/tab) o Doxycycline 100 mg q12h. Sa first-line failure o may comorbidities (DM, CHF, CKD), Levofloxacin 750 mg OD x 5 days (P50-150/tab). Hindi self-medicate, dapat doctor-prescribed.
Kailangan ba talaga ng confinement kapag may pulmonya?
Hindi lahat. Karamihan ng mild CAP ay outpatient lang. Pero dapat magpa-confinement kung may CURB-65 risk factors: edad 65+, BP <90 systolic, RR >30, confusion, BUN elevated, SpO2 <92%, multilobar pneumonia, may DM/CHF/COPD/CKD, hindi makainom o makakain. PhilHealth ay nag-cover ng pulmonya confinement case rate (P15,000-32,000 depending sa severity). Mas mainam ang inpatient sa mga elderly at may comorbidities para sa IV antibiotic at oxygen support.
Ilang araw bago gumaling sa pulmonya?
Antibiotic course ay 5-7 days para sa karaniwang CAP, 10-14 days kung may complications. Pero ang full clinical recovery ay matagal: 7-10 days para mawala ang fever at ubo, 4 weeks para sa fatigue at limited exercise tolerance, 6-8 weeks para sa full lung function. Para sa 50+ years old o smokers, follow-up chest x-ray sa 6-8 weeks para ma-rule out ang malignancy. Hindi mawala ang ubo ng 4 weeks ay normal, basta lumiliit ang severity.
Pwede ba bilhin ang antibiotic for pneumonia nang walang reseta?
Sa technical PH law, hindi. Pero sa reality, nabili sa ilang botika ng walang Rx. HUWAG ITO. Self-medication ng antibiotic ay nagdudulot ng: (1) wrong drug para sa specific bacterial cause = partial treatment + relapse, (2) antibiotic resistance na nagiging panganib sa buong population, (3) masked symptoms na nakakatakot sa TB pneumonia o atypical pathogens, (4) drug interactions at side effects na hindi monitored. Magpa-Internal Medicine o Family Medicine para sa proper assessment at Rx. NowServing same-day online consult available.
May Sintomas ng Pulmonya?
Persistent ubo + lagnat 3+ days kasama ang shortness of breath = posibleng pulmonya. Magpa-konsulta agad sa Internal Medicine o Pulmonology sa NowServing.
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Internal Medicine MD Find a PulmonologistDisclaimer: Ang impormasyon dito ay para sa edukasyon lang at hindi ito pumapalit sa konsulta sa doctor. Hindi ito medical advice at hindi dapat gamitin para mag-self-medicate. Ang lahat ng antibiotics sa pulmonya ay prescription-required. Self-medication ay nagdudulot ng antibiotic resistance at potential treatment failure. PhilHealth coverage ay base sa case rate at hospital tier. Reference: PSMID 2020 Adult CAP CPG. Ang mga presyo ay pwedeng magbago.