Anaerobes in Aspiration Pneumonia

A is admitted to the with fever and hypoxia with a new infiltrate on

Staff at his nursing home note concern for aspiration. The patient is currently on ceftriaxone and azithromycin.

Is empiric anaerobic coverage needed?

Yes! Cover anaerobes
No, not needed

How did others respond?

Reveal the answer

Best Answer

No, anaerobic coverage is not needed ⛔️

Explanation: 2019 ATS/IDSA Guidelines recommend AGAINST routine coverage of anaerobes EVEN in the setting of suspected aspiration 🩻

The guidelines cite evidence that anaerobes are rarely isolated from respiratory samples 🧫 Even when anaerobes grow, patients often improve without anaerobic coverage 🤯

So are there times when empiric anaerobic coverage is reasonable? Yes! In the setting of walled off infections, there may be a more favorable environment for anaerobic growth 🧫 This includes:
-lung abscess
-empyema
-necrotizing pneumonia

Aspire to avoid unnecessary anaerobic coverage in aspiration!