On the other hand, regarding reducing acidity of the stomach, an acid environment is needed to kill the organisms that colonize the gastrointestinal tract; agents, such as proton pump inhibitors, that decrease the acidity of the stomach, may favor the growth of bacteria and increase the risk of pneumonia. Treatment
Adjusting the patients posture should come first, then the oropharyngeal contents should be suctioned with the nasogastric tube in place. Humidified oxygen is given to patients who are not intubated, and the head end of the bed should be elevated by 45 degrees. Its crucial to keep a close eye on the patients oxygen saturation, and if hypoxia is detected, urgent intubation with mechanical breathing should be given. Flexible bronchoscopy is often used to gather samples of bronchoalveolar lavage for quantitative bacteriological tests as well as high volume aspiration to clear the secretion. In general practice The main treatment of aspiration pneumonia revolves around the use of antibiotics to remove the bacteria causing the infection. Broad antibiotic coverage is required to account for the diverse types of bacteria possibly causing the infection. Even though they are not necessary in cases with aspiration pneumonitis, antibiotics are typically started right away to stop the diseases development.Recommended antibiotics include clindamycin, meropenem, ertapenem, ampicillin/sulbactam, and moxifloxacin. Treatment with piperacillin/tazobactam, cefepime, levofloxacin, imipenem, or meropenem is recommended in cases of potential antibiotic resistance. The typical duration of antibiotic therapy is about 5 to 7 days.
Elderly
Aging increases the risk of dysphagia. The prevalence of dysphagia in nursing homes is approximately 50%, and 30% of the elderly with dysphagia develop aspiration. For individuals older than 75, the risk of pneumonia due to dysphagia, is six times greater than those 65. Owing to multiple factors, such as frailty, impaired efficacy of swallowing, decreased cough reflex and neurological complications, dysphagia can be considered as a geriatric syndrome. Atypical presentation is common in the elderly. Older patients may have impaired T cell function and hence, they may be unable to mount a febrile response. The mucociliary clearance of older people is also impaired, resulting in diminished sputum production and cough. Therefore, they can present non-specifically with different geriatric syndromes. Microaspirations
In the elderly, dysphagia is a significant risk factor for the development of aspiration pneumonia. Aspiration pneumonia most often develops due to micro-aspiration of saliva, or bacteria carried on food and liquids, in combination with impaired host immune function. Chronic inflammation of the lungs is a key feature in aspiration pneumonia in elderly nursing home residents and presents as a sporadic fever (one day per week for several months). Radiological review shows chronic inflammation in the consolidated lung tissue, linking chronic micro-aspiration and chronic lung inflammation. Choking
After falls, choking on food presents as the second highest cause of preventable death in aged care. Although food choking risk is commonly associated with young children, data shows that individuals over 65 years of age have a choking incidence that is seven times higher than children aged 1–4 years.