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782
The efficacy of anaerobe specific antibiotics in patients with aspiration pneumonia

Session: Poster Abstract Session: Clinical Respiratory Infections
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • Aspiration PNA Kory. key. copy.pdf (166.4 kB)
  • Background: IDSA/ATS guidelines state that anaerobic coverage is indicated only for aspiration pneumonia in patients with a history of loss of consciousness as a result of alcohol/drug overdose or after seizures in patients with concomitant gingival disease or esophageal motility disorders. Despite this, clinicians often add anaerobic coverage in patients without these risk factors.  Given the paucity of  studies on anaerobe specific antibiotics in aspiration pneumonia, we assessed their efficacy by comparing patients treated with and without anaerobe specific antibiotics.

    Methods: A single-center retrospective cohort study that compared a group of aspiration pneumonia patients treated with anaerobe specific antibiotics to a group of patients without anaerobe specific antibiotics. All medical records with a discharge diagnosis of aspiration pneumonia were reviewed. Inclusion criteria were the presence of risk factors for aspiration as well as imaging findings consistent with pneumonia.  Main outcomes included length of stay, inpatient mortality, and need for change in antibiotics. 

    Results: 636 patients with a diagnosis code of aspiration pneumonia were identified.  390 patients met all  inclusion criteria.  279 patients received initial anaerobe specific coverage while 111 did not.  Apache II and PORT scores were similar (10.5±4.6 vs. 10.5±4.4) and (110±30 vs.  108±32) respectively.  No significant differences in length of stay (10.5 vs. 11.5 days (p=0.29), or mortality (13% vs. 18%, p=0.20) were detected. A change in antibiotics occurred more often in patients initially treated without anaerobic coverage (24% vs. 38% p<.01).

    Conclusion: In this retrospective study of patients hospitalized with aspiration pneumonia, no difference in mortality or length of stay were detected between patients initially treated with anaerobe specific antibiotics and those without, however patients not receiving initial anaerobic coverage were more likely to have a change in antibiotics. Prospective studies on the role of anaerobe specific antibiotics in aspiration pneumonia are needed.

    Hirokazu Ban, M.D., Department of Internal Medicine, Mount Sinai beth Israel, new york, NY, Kory Pierre, M.D., Pulmonary/Critical Care, Mount Sinai Beth Israel, New york, NY, Christina Nadar, M.D., Internal Medicine, Mount Sinai Beth Israel, new york, NY, Takeru Yamamoto, M.D., Infectious Disease, Mount Sinai Beth Israel, New york, NY, Anita Bhagavath, M.D., Internal Medicine, Beth Israel Medical Center, New York, NY and Michael Silverberg, M.D., Pulmonary/Critical Care, Mount Sinai Beth Israel, New York, NY

    Disclosures:

    H. Ban, None

    K. Pierre, None

    C. Nadar, None

    T. Yamamoto, None

    A. Bhagavath, None

    M. Silverberg, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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