Aspiration Pneumonia or Post-op Chest Infection

Antimicrobial prescribing: NHS Forth Valley
NHS Forth Valley

Micro Organisms

Mouth flora (including anaerobes)

Always check previous cultures 

First Line - (Mild)

Therapy

No treatment required - aspiration pneumonia is often a chemical injury - antibiotics not indicated

Notes:

First Line - (Moderate)

Therapy

Amoxicillin PO for 3-5 days

(Use IV only if unable to tolerate oral)

Notes:

First Line - (Severe)

Therapy

Co-amoxiclav PO/IV for 3-5 days

Notes:

Consider IV to oral switch when afebrile > 24 hours and clinically improving

Penicillin Allergy (Anaphylaxis) - (Moderate)

Therapy

Cefuroxime PO

(Use IV only if unable to tolerate oral. If oral solution is required co-trimoxazole is a suitable alternative)

Notes:

Penicillin Allergy (Anaphylaxis) - (Severe)

Therapy

Vancomycin IV + Ciprofloxacin PO + Metronidazole PO  for 3-5 days

(use IV only if unable to tolerate oral therapy)

Notes:

Consider IV to oral switch when afebrile > 24 hours and clinically improving

Notes

Children with complex neurological conditions may need a more prolonged course of treatment. Discuss with microbiology

The most important treatments for post-op chest infections are physiotherapy, adequate analgesia and mobilisation.