HCAP

Prophylactic antibiotics ARE NOT recommended for patients who are at increased risk for aspiration.

Immediate treatment is indicated for patients who have small-bowel obstruction or are on acid suppression therapy given the increased risk of gastric colonization.

Antibiotic treatment of patients who develop fever, leukocytosis, and infiltrates in the first 48h after an aspiration is likely UNNECESSARY since most aspiration pneumonias are chemical and antibiotic treatment may only select for more resistant organisms.

Treatment IS recommended for patients who have symptoms for more than 48 hours or who are severely ill.