Aspiration pneumonia bacterial infection medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Priyamvada Singh, M.D. [2]

Medical therapy

Antibiotics

• Treatment of choice clindamycin
  • Doses 600 mg Q8hourly, followed by 300 mg Q6hourly, or 450 mg tid
  • Advantage of clindamycin :
    • Cheap
    • Less incidences of superimposed MRSA
• Other agents used: Ampicillin-sulbactam (1.5 g or 3 g twice daily), Imipenem (Invanz 500 mg BID), amoxicillin-clavulnate (875 mg orally bid), penicillin (1 to 2 million units IV Q6hourly) / amoxicillin (500 mg orally tid)+ metronidazole (500 mg orally or IV tid).
• Monotherapy with metronidazole is not preferred as high failure rates have been reported. This is because metronidazole is ineffective against some pathogens such as microaerophilic and aerobic streptococci