Abstract
Aspiration pneumonia is pneumonia resulting from abnormal entry of food or oral content into the lower airway. Oral streptococci and anaerobes are therefore thought to play an important role in its etiology. Moreover, the common pathogens detected in pneumonia patients without aspiration are also isolated from patients with aspiration pneumonia.
Selection of antimicrobials for use in aspiration pneumonia is standardized by the Japanese Respiratory Society guidelines for nursing and healthcare-associated pneumonia, taking severity, sepsis, and risk of drug-resistant pathogens into consideration. Escalation or de-escalation tactics are decided taking into account the clinical history of the patient. A regimen with activity against both aerobes and anaerobes should be selected as an empirical therapy. In general, penicillin combined with a β-lactamase inhibitor is recommended as the first-line antimicrobial. Patients who are initially treated with parenteral antimicrobials can be switched to oral ones once they show clinical improvement.
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Ishida, T. (2020). Antimicrobial Selection for Aspiration Pneumonia: What Is the Important Point of Antimicrobial Selection for Aspiration Pneumonia?. In: Teramoto, S., Komiya, K. (eds) Aspiration Pneumonia. Respiratory Disease Series: Diagnostic Tools and Disease Managements. Springer, Singapore. https://doi.org/10.1007/978-981-15-4506-1_7
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