Aspiration Pneumonia

Severity
(classification)

 

1st line oral/iv antibiotics

 

Penicillin allergy

(see explanatory notes)

A/B

Minor to
severe infection

 

Review doses in renal impairment

CO-AMOXICLAV 625mg po tds

Typical duration: 5 days

LEVOFLOXACIN 500mg po bd
(Consider reducing to 500mg od if patient clearly improving)
plus
METRONIDAZOLE 400mg po tds

Typical duration: 5 days

C

Severe life threatening infection

 

Review doses in renal impairment

CO-AMOXICLAV 1.2g iv tds

(NOTE: if known/suspected Clostridium difficile infection currently or within the last 3 months then discuss with microbiology)

 

If suspected MRSA, ADD:

VANCOMYCIN iv (as per local policy)

 

*LEVOFLOXACIN 500mg po/iv bd
(Oral route preferred. Consider reducing to 500mg od if patient clearly improving)

plus

VANCOMYCIN iv (as per local policy)
plus

METRONIDAZOLE 400mg po tds
(500mg iv tds treatment only if critically ill, nil by mouth, or concern re. patient's ability to absorb drugs following oral administration)

*NOTE: if iv levofloxacin is required and there is no stock available, please switch the levofloxacin to:
CIPROFLOXACIN 400mg iv bd


IV to Oral Switch

(explanatory notes)

CO-AMOXICLAV 625mg po tds

If suspected MRSA: Discuss with microbiologist

Typically for a total of 7- 10 days therapy

LEVOFLOXACIN 500mg po bd
(Consider reducing to 500mg od if patient clearly improving)

plus
 

METRONIDAZOLE 400mg po tds

If suspected MRSA: Discuss with microbiologist

Typically for a total of 7- 10 days therapy

Last reviewed: 09/05/17

For guidance on the administration of intravenous antibiotics
click here (GHNHSFT intranet only)