Aspiration Pneumonia

First Line

If < 5days since admission:

  • Amoxicillin 1g IV 8 hourly AND Metronidazole 500mg IV 8 hourly

 

 If ≥ 5 days since admission, severe infection, sepsis:

  • Amoxicillin 1g IV 8 hourly AND Metronidazole 500mg IV 8 hourly AND Gentamicin IV as per protocol
Penicillin Allergy

If < 5days since admission

  • Clarithromycin 500mg IV 12 hourly AND Metronidazole 500mg IV 8 hourly

 

If ≥ 5 days since admission and mild-moderate infection without sepsis:

  • Co-trimoxazole 960mg IV 12 hourly AND Metronidazole 500mg IV 8 hourly

If ≥ 5 days since admission and severe infection / sepsis:

  • Levofloxacin 500mg IV 12 hourly (consider safety issues) AND Metronidazole 500mg IV 8 hourly 

 

Notes

Send sputum when possible

Treatment duration: 5-7 days. If very prompt clinical response 3 days may be adequate.

Review daily for IV to PO switch