- Aspiration Pneumonia = aspiration of oropharyngeal contents which includes colonizing flora and leads to infection.
- Elderly have increased colonization with Staph aureus, aerobic gram-negative bacilli (Klebsiella and Escherichia coli) + dysphagia = pneumonia
- distinguishing from aspiration pneumonitis may be difficult, and the distinction is controversial.
- generally not witnessed
- typical symptoms
- infiltrate in bronchopulmonary segment
- those that aspirate in recumbent position -> posterior segments up upper lobes
- those that aspirate upright -> basal segments of lower lobes
- higher chance of cavitation and lung abscess formation
-> benzylpenicillin + metronidazole
-> or clindamycin
- – if aerobic gram –ve bacilli suspected (alcoholic patients)
-> metronidazole + ceftriaxone/cefotaxime/piperacillin-tazobactam/ticarcillin+clavulanate
- – once defervesce -> amoxicillin-clavulanate or clindamycin
- 7 days of total therapy usually adequate