Legionella pneumonia prevention

Atypical cases of pneumonia may be caused by Mycoplasma pneumoniae which may be epidemic, or more rarely Chlamydia pneumoniae or psittaci (psittacosis/ornithosis) Legionella pneumophilia or Coxiella burnetii (Q fever) and a tetracycline or erythromycin/ clarithromycin should be given by mouth. Treatment of ornithosis should continue for 10 days after the fever has settled and in mycoplasma pneumonia and Q fever a total of 3 weeks treatment may be needed to prevent relapse. 

The answer is a. (Murray, pp 452-467. Scriver, pp 3-45. Sack, pp 1-40. Wilson, pp 101—120.) Virulent strains of bacteria that cause severe, life-threatening respiratory tract infections can often be successfully treated with erythromycin. These include Mycoplasma pneumoniae, various Legionella species, and Bordetella pertussis. The mechanism of action of erythromycin is to specifically bind the 50S subunit of bacterial ribosomes. Under normal conditions, after mRNA attaches to the initiation site of the 30S subunit, the 50S subunit binds to the 30S complex and forms the 70S complex that allows protein chain elongation to go forward. Elongation is prevented in the presence of erythromycin. 

Table 5 Risk Factors and Preventive Measures for Nosocomial Legionella and Viral Pneumonia...

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