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Aspiration Pneumonitis and Aspiration Pneumonia

Division of Pulmonary and Critical Care Medicine, Thomas Jefferson University
Philadelphia, PA

Aspiration pneumonitis and aspiration pneumonia are common entities that occur more frequently in populations that are susceptible to aspiration. In aspiration pneumonitis, the degree of lung injury caused by the aspiration of gastric contents is influenced by the pH and to a lesser extent volume of the aspirate. In aspiration pneumonia, the key precipitating event is the inhalation of colonized oropharyngeal material. While anaerobic bacteria are the classic organisms associated with aspiration pneumonia, gram-negative bacteria also play an important role in its pathogenesis. Although there is enormous potential for the investigation of strategies aiming the prevention of aspiration pneumonia, most studies have failed to show a benefit of these strategies. Recently published clinical trials have evaluated the efficacy of different antibiotic regimens for the treatment of aspiration pneumonia. Importantly, new and simplified antibiotic regimens have emerged as an option for the treatment of aspiration pneumonia.