Aspiration Pneumonia

  • Aspiration pneumonitis is a sterile chemical inflammatory process caused by aspiration of gastric acid. Antibiotics are NOT indicated in aspiration pneumonitis

  • The vast majority of aspiration pneumonia cases are indistinguishable from CAP and HAP – with respect to presentation, microbiology, and therapy

  • Classic aspiration pneumonia has a protracted onset with putrid sputum and often a lung abscess or empyema. Anaerobes play a larger role in classic aspiration pneumonia

Diagnosis

The diagnosis of pneumonia is based on suggestive clinical features (cough, fever, sputum production, pleuritic chest pain, dyspnea) AND a new chest x-ray infiltrate

Pneumonia takes several days to develop after an aspiration event

All patients with suspected aspiration pneumonia should have a chest X-ray. Sputum culture should be collected if risk factors for antibiotic resistant organisms are present

Empiric Treatment