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Aspiration Pneumonia

  • Chapter
Community-Acquired Pneumonia

Conclusions

In summary, aspiration pneumonia is the result of large-volume aspiration into the lower airways of material from the upper respiratory or digestive tracts. Aspiration is suspected in approximately 10% of patients hospitalized due to CAP. The syndrome is subdivided into three different forms, depending on the nature of the inoculum, and each form has specific clinical presentations and therapies. These presentations include toxic injury of the lung (Mendelson’s syndrome), obstruction by foreign bodies or fluids, and infection. Aspiration pneumonia should be suspected in those patients with pulmonary infiltrates and a predisposing cause of aspiration (e.g., dysphagia or fall in consciousness Anaerobes should be suspected in the presence of periodontitis, putrid discharge, infection complicating obstruction, and necrosis of tissue with cavitation or abscess formation. Empiric antibiotic coverage for suspected pathogens (anaerobic predominance) is generally appropriate. Penicillin and clindamycin, until recently the drugs of choice, should now be considered second-line therapies due to the progressive emergence of resistance; these agents should therefore be used with caution when selected empirically. Currently, &β-lactam/&β-lactamase inhibitor combination is the therapy of choice. Carbapenems are equally effective, but more expensive. Fourth-generation quinolones are excellent alternatives in patients with &β-lactam hypersensitivity.

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Authors and Affiliations

  1. Intensive Care Department, Hospital Doce de Octubre, Madrid, Spain

    Marcio Sa-Borges

  2. Critical Care Department, Hospital University Joan XXIII, University Rovira & Virgili, Carrer Dr. Mallafre Guasch, 43007, Tarragona, Spain

    Jordi Rello

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  1. Marcio Sa-Borges
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  1. University of Alberta, Edmonton, Alberta, Canada

    Thomas J. Marrie

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Sa-Borges, M., Rello, J. (2002). Aspiration Pneumonia. In: Marrie, T.J. (eds) Community-Acquired Pneumonia. Springer, Boston, MA. https://doi.org/10.1007/0-306-46834-4_15

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