Chest

Community-acquired aspiration pneumonia: Do patients really need extended anaerobic coverage?

February 28, 2024

Extended anaerobic coverage isn’t likely necessary for community-acquired aspiration pneumonia. Researchers found no mortality benefit but did uncover an increased risk of C. diff colitis in this multicenter retrospective cohort study.

• Clinical practice guidelines for aspiration pneumonia don’t recommend antibiotics with extended anaerobic coverage.
• This retrospective cohort study across 18 hospitals included patients admitted for community-acquired aspiration pneumonia. All received parenteral antibiotics within 48 hours of admission: 2,683 received limited anaerobic coverage, 1,316 received extended anaerobic coverage. Limited anaerobic coverage included ceftriaxone, cefotaxime, or levofloxacin; extended coverage included amoxicillin-clavulanate, moxifloxacin, or ceftriaxone, cefotaxime, or levofloxacin combined with either clindamycin or metronidazole.
• Death in hospital occurred in 30.3% of those with limited anaerobic coverage vs. 32.1% of those on extensive coverage.
• C. difficile colitis occurred in ≤0.2% of those on limited anaerobic coverage vs. 0.8% to 1.1% of patients on extended coverage.

Source:

Bai AD, et al. (2024, February 20). Chest. Anaerobic antibiotic coverage in aspiration pneumonia and the associated benefits and harms: A retrospective cohort study. https://pubmed.ncbi.nlm.nih.gov/38387648/