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Monday, October 21, 2019

Aspiration Syndromes

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emDocs - October 21, 2019 - Authors: Huynh N and Scott K
Reviewed by: Koyfman A, Long B and Montrief T
"Take Home Points 
  • Distinguishing between aspiration pneumonitis and aspiration pneumonia remains a clinical diagnosis.
  • Chest X-ray findings of infiltrates in dependent parts of the lung can suggest aspiration but do not help distinguish between aspiration pneumonia and pneumonitis.
  • Mild to moderate cases of aspiration pneumonitis do NOT benefit from antibiotics. Consider holding antibiotics and monitoring for 24-48 hours after symptom onset.
  • Current guidelines for antibiotic choice for aspiration pneumonia recommend beta-lactam/beta-lactamase inhibitor or clindamycin as first-line with flagyl being ineffective for anaerobic coverage. However, more recent data strongly suggests that anaerobic coverage may not be needed and may be considered in certain at-risk groups, but otherwise standard pneumonia regimens can be used.
  • Corticosteroids are NOT recommended in management of aspiration pneumonia or pneumonitis"