Guidelines
Aspiration Pneumonia

Aspiration Pneumonia

Definitions

A chemical injury caused by the inhalation of gastric contents

  • Abrupt onset/resolution

  • Fever resolves in 24-48 hours

  • Hypoxemia resolves in 24-48 hours

An infectious process caused by the inhalation of oropharyngeal secretions that are colonized by pathogenic bacteria

  • Slow onset/not acute

  • Fever not resolving

  • Hypoxemia ongoing

Key Points

Most people with aspiration do not develop pneumonia and can be managed with the wait and watch approach

Fever, crackles, and new chest radiograph (CXR) opacification can be seen in both aspiration pneumonitis and pneumonia

If patient is stable, monitor for signs and symptoms for 48 hours; antibiotics are not required

Antibiotic treatment of patients who develop fever, leukocytosis and infiltrates in the first 48 hours after an aspiration event is likely unnecessary and may only select for resistant organisms