Clinical Significance of Aspiration Pneumonia in All the Pneumonia Therapy: The Impact of Aspiration Pneumonia on the Therapeutic Approach for All Pneumonia

Abstract

Pneumonia is commonly seen in all ages, but the morbidity and mortality of pneumonia increase drastically with age. A large number of pneumonia patients are the elderly who also have a high risk of aspiration. Compared to patients with non-aspiration pneumonia, patients with aspiration pneumonia show poorer prognosis, not only in the short-term but also in the long-term. The pathophysiologies of aspiration, aspiration pneumonia, and elderly pneumonia overlap, and these are very close disease entities. In addition to proper diagnosis and treatment of pneumonia in the elderly and patients with aspiration risks and aspiration pneumonia, prophylactic approach and nutritional evaluation are also important for the management of these patients. As standard diagnostic criteria of aspiration pneumonia have not been established, diagnosis of aspiration pneumonia is usually made by compatible findings on chest radiography that shows infiltrative shadows and gravity-dependent lung segments with characteristic clinical history and risk factors for aspiration. Therapeutic approach for aspiration pneumonia is the combination of antimicrobials against causative pathogens of pneumonia, treating malnutrition and comorbid illnesses, rehabilitation and reevaluation of all medications. In addition to proper diagnosis and treatment, appropriate preventive strategies such as pneumococcal and influenza vaccinations and keeping good nutrition status are necessary for better prognosis not only in patients with aspiration pneumonia but in patients with aspiration risks.