Oral or enteral antibiotic therapy for aspiration pneumonia in patients who are not improving on empirical therapy for HAP

To determine whether the below regimens are appropriate for a patient with aspiration pneumonia who has not improved on the empirical regimen for HAP, see Management of aspiration pneumonia in patients who are not improving on empirical therapy for CAP or HAP. If appropriate, add to the empirical regimen for HAP:

metronidazole 400 mg (child: 10 mg/kg up to 400 mg) orally or enterally, 12-hourly. See advice on duration of therapy. metronidazole metronidazole metronidazole

For patients with penicillin hypersensitivity, as a single-drug regimen, use:

moxifloxacin 400 mg (child: 10 mg/kg up to 400 mg) orally or enterally, daily. For dosage adjustment in adults with kidney impairment, see moxifloxacin dosage adjustment. See advice on duration of therapy ¹ ². moxifloxacin moxifloxacin moxifloxacin

¹ Moxifloxacin is not licensed for use in children on the basis of animal studies that showed an adverse effect on cartilage development with quinolone use; however, clinical trial data suggest that adverse musculoskeletal events are usually mild and short term, similar to those observed in adults. Moxifloxacin can be used in children when it is the drug of choice.Return

² An oral liquid formulation of moxifloxacin is not commercially available; for formulation options for children or people with swallowing difficulties, see Don’t Rush to Crush, which is available for purchase from the Advanced Pharmacy Australia website or through a subscription to eMIMSplus.Return