【Common Diseases】Pneumonia

[Editor's In-depth Analysis] A Complete Guide to Pneumonia Treatment and Care in Hong Kong

What is pneumonia?

Pneumonia refers to inflammation of the alveoli (sacs) in the lungs, often caused by infection with bacteria, viruses, fungi or other microorganisms.
In Hong Kong, pneumonia is a common fatal disease among the elderly. Hospital Authority data shows that pneumonia has long been a leading cause of death in the city. Healthy adults, children, and high-risk groups are all at risk of infection.

Common types of pneumonia in Hong Kong

  1. Community-acquired pneumonia (CAP)
    • Common pathogens of community-acquired infections are Streptococcus pneumoniae and Haemophilus influenzae.
  2. Nosocomial pneumonia (HAP)
    • Pneumonia that occurs 48 hours after admission is commonly caused by Staphylococcus aureus (including MRSA) and Pseudomonas aeruginosa.
  3. Aspiration pneumonia
    • It is caused by aspiration of food, gastric juices, or foreign objects into the lungs, often in people with dysphagia.
  4. viral pneumonia
    • Pneumonia caused by influenza virus and new coronavirus can be fatal in severe cases.

Common symptoms

  • Fever (up to 39°C or higher)
  • Cough (with phlegm, which may be yellow-green or stained with blood)
  • Shortness of breath/difficulty breathing
  • Chest pain (worse with deep breathing or coughing)
  • Fatigue and loss of appetite
  • Elderly people may experience atypical symptoms, such as confusion and decreased appetite.

Editor's reminder:

If you experience a sudden onset of high fever, shortness of breath, or chest pain, especially if you are elderly, infants, or people with chronic illnesses, you should seek medical attention as soon as possible, as pneumonia can progress rapidly.

Principles of treatment for pneumonia

Treatment depends on the cause, severity , and patient background (age, immune status, and presence of underlying medical conditions).
Treatment goals:

  1. Eliminate infection
  2. Relieve symptoms
  3. Preventing complications
  4. Restoring lung function

1. Bacterial pneumonia treatment (antibiotics)

  • Drug of choice (community-acquired pneumonia):
    • Amoxicillin
    • Amoxicillin-clavulanic acid (Augmentin)
    • Macrolides (eg, clarithromycin, azithromycin)
    • Respiratory fluoroquinolones (such as Levofloxacin)
  • Nosocomial pneumonia : Injectable broad-spectrum antibiotics (such as Piperacillin/Tazobactam, Cefepime, Meropenem) may be needed, and treatment should be targeted at drug-resistant bacteria.
  • Treatment duration : Usually 5-7 days (mild cases), may be extended to 10-14 days for severe or drug-resistant infections.

⚠️ Editor's reminder:

Do not purchase antibiotics on your own or stop taking them midway, as this will lead to drug resistance and make treatment more difficult.

2. Treatment of viral pneumonia

  • Influenza virus : Antiviral drugs (Oseltamivir, Zanamivir) are available, and they are most effective when used within 48 hours of onset.
  • Novel Coronavirus : According to the guidelines of the Hospital Authority, antiviral drugs (such as Paxlovid, Remdesivir) and supportive treatment may be used.
  • Other viruses : Supportive treatment is mainly used (fever reduction, hydration, oxygen).

3. Antifungal treatment

  • For pneumonia caused by fungi (such as Candida albicans and Aspergillus), special antifungal drugs (such as Voriconazole and Amphotericin B) are used and require a prescription from a specialist.

4. Supportive care

  • Oxygen therapy : People with hypoxia need to use nasal cannula or mask to provide oxygen.
  • Antipyretic and analgesic drugs : such as Paracetamol to relieve discomfort.
  • Fluid replacement : Prevent dehydration.
  • Expectorant and respiratory physiotherapy : Helps clear secretions.
  • Nutritional support : especially for the elderly and critically ill patients.

5. Hospitalization and intensive care

The following situations often require hospitalization:

  • Dyspnea or oxygen saturation < 92%
  • Persistent high fever
  • confusion
  • low blood pressure
  • Have serious chronic illnesses (heart disease, kidney disease, immune deficiency)
  • Imaging shows extensive infection in both lungs

People with severe illness may need:

  • High flow oxygen
  • Non-invasive or invasive ventilator
  • Intensify antibiotics or combine them

Editor's Tips for Preventing Pneumonia

  • Pneumococcal vaccination (PCV13 / PPSV23): The Hong Kong Department of Health provides subsidies for high-risk groups.
  • Get a flu shot every year to reduce the risk of viral pneumonia.
  • Wash your hands frequently, wear a mask, and reduce contact with respiratory pathogens.
  • Maintain a balanced diet and exercise regularly to enhance immunity.
  • Quit smoking and avoid exposure to secondhand smoke.

Medical resources in Hong Kong

  • Public hospital emergency room : handling severe pneumonia.
  • General Outpatient Clinic/Private Clinic : Diagnosis and follow-up of mild pneumonia.
  • Community pharmacies : You can buy supportive treatment medicines (you cannot buy antibiotics on your own).
  • Department of Health Vaccination Programme : provides influenza and pneumococcal vaccines.

💡Editor 's Summary <br>Pneumonia is more than just a "bad cough"—it can be life-threatening in a short period of time, especially for the elderly, infants, or those with weakened immune systems. Hong Kong has comprehensive diagnostic and treatment resources. The key is to seek medical attention early, follow your doctor's orders to complete the course of treatment, and take preventive measures . Prevention, rather than treatment, is the best way to protect yourself and your family.

Disclaimer : This article is for reference only and does not constitute any medical advice. The source is referenced from major medical articles.

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