Most patients with aspiration event do not develop pneumonia; antibiotics are NOT required for aspiration pneumonitis.
Patients with adequate respiratory reserve can be monitored safely off antibiotics.
Fever and new chest radiograph (CXR) opacification can be seen in both aspiration pneumonitis and pneumonia.
Piperacillin-tazobactam is not first line therapy for hospital acquired “aspiration” pneumonia and should be reserved for patients at high risk for antibiotic resistant organisms.
Not witnessed, but high risk of aspiration based on history OR predisposing conditions: reduced LOC, impaired cough and/or gag reflex, esophageal disease, tracheostomy, NG feeds, protracted vomiting.
Witnessed aspiration two to five hours before respiratory deterioration.