Aspiration Pneumonia or Post-op Chest Infection

Micro-organism

Mouth flora (including anaerobes)

First Line

Co-amoxiclav IV for 7 days

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

Second line: mild intolerance or mild skin reaction

Cefuroxime IV and Metronidazole IV for 7 days

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

Anaphylaxis (including severe skin reactions) to penicillin / cephalosporins

Vancomycin IV + Ciprofloxacin IV/PO + Metronidazole IV/PO  for 7 days

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.