When are antibiotics indicated in the treatment of aspiration pneumonia?

Updated: Aug 15, 2018
  • Author: Justina Gamache, MD; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Antibiotics are indicated for aspiration pneumonia. However, for aspiration pneumonitis, early presumptive antibiotics (ie, prophylactic) are not recommended. This practice is believed to lead to the selection of more resistant organisms. [22] In addition, those patients with recent aspiration, fever, and leukocytosis should not be treated even in the presence of a pulmonary infiltrate due to the risk of development of resistant organisms. The following situations call for the use of antibiotics in managing pneumonitis:

  • Administer antibiotics if the pneumonitis fails to resolve within 48 hours.

  • Patients with small-bowel obstruction, particularly of the lower region, should receive antibiotics (bacteria may colonize the gastric contents).

  • Antibiotics should be considered for patients on antacids due to the potential for gastric colonization with micro-organisms.

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