Treatment of Aspiration Pneumonia in Patients with Penicillin Allergy
Managing aspiration pneumonia requires antibiotic selection tailored to the patient's history. When penicillin allergy is documented or the standard oral or intravenous route is not an option, a specific evidence-based alternative is indicated.
Clinical Scenario
Patient with aspiration pneumonia who has a history of penicillin allergy without any contraindication to third-generation cephalosporins, or for whom the oral or intravenous route of administration cannot be used.
Treatment Approach Partial preview
This protocol centres on a third-generation cephalosporin administered by a route that avoids vascular access, supporting treatment adherence while limiting risks associated with vascular devices. The full regimen — including all specifications and exclusions — is available in the complete protocol.
Clinical Success — Assessed at 72 Hours
- Temperature ≤ 37.8 °C
- Systolic BP ≥ 90 mm Hg
- Heart rate ≤ 100/min
- Respiratory rate ≤ 24/min
- SpO₂ ≥ 90% or PaO₂ ≥ 60 mm Hg (ambient air)
References
DOI: 10.1016/j.idnow.2025.105081
- Second choice (when the first choice cannot be used, especially in patients with an allergy to penicillin without any contraindication to third-generation cephalosporins (3GC) and/or when the oral or IV route cannot be used): subcutaneous (SC) ceftriaxone (Grade B-1)
- The administration of subcutaneous ceftriaxone as one injection per day ensures treatment compliance while limiting iatrogenic effects linked to vascular devices.
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