Suspected Aspiration

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

Empiric coverage for aspiration is justified only in classic aspiration syndromes suggested by loss of consciousness (e.g. overdose, seizure) PLUS gingival disease or esophageal motility disorder.