Aspiration pneumonitis is an acute lung injury resulting from the aspiration of gastric contents
It is an inflammatory condition rather than infectious
Despite the inflammation, corticosteroids have been shown to have no effect on mortality
Aspiration pneumonitis is self limited
Antibiotics are generally held for 24 to 48 hours
When to consider empiric broad spectrum antibiotics in the ED: Gastric contents are sterile in most patients. Patients who may have colonization/contamination of gastric contents are more likely to progress from pneumonitis to pneumonia. Consider empiric antibiotics for aspiration pneumonitis in the patient with SBO, gastroparesis, those receiving enteral feeds through a G- or J-tube, and those on chronic PPI's/antacids.
