title: Aspiration pneumonia: a review of modern trends.
abstract: OBJECTIVE
  The purpose was to describe aspiration pneumonia in the context of other lung infections and aspiration syndromes and to distinguish between the main scenarios commonly implied when the terms aspiration or aspiration pneumonia are used. Finally, we aim to summarize current evidence surrounding the diagnosis, microbiology, treatment, risks, and prevention of aspiration pneumonia.
  
  
  METHODS
  Medline was searched from inception to November 2013. All descriptive or experimental studies that added to the understanding of aspiration pneumonia were reviewed. All studies that provided insight into the clinical aspiration syndromes, historical context, diagnosis, microbiology, risk factors, prevention, and treatment were summarized within the text.
  
  
  RESULTS
  Despite the original teaching, aspiration pneumonia is difficult to distinguish from other pneumonia syndromes. The microbiology of pneumonia after a macroaspiration has changed over the last 60 years from an anaerobic infection to one of aerobic and nosocomial bacteria. Successful antibiotic therapy has been achieved with several antibiotics. Various risks for aspiration have been described leading to several proposed preventative measures.
  
  
  CONCLUSIONS
  Aspiration pneumonia is a disease with a distinct pathophysiology. In the modern era, aspiration pneumonia is rarely solely an anaerobic infection. Antibiotic treatment is largely dependent on the clinical scenario. Several measures may help prevent aspiration pneumonia.
authors.affiliation: Department of Pulmonary, Allergy, and Critical Care Medicine, Columbia University, New York, NY. Electronic address: dd2714@columbia.edu.
authors.forename: David M
authors.initials: DM
authors.lastname: DiBardino
authors.affiliation: Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Wunderink
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001420:Bacteria, Aerobic; D001421:Bacteria, Anaerobic; D003428:Cross Infection / Q000145:classification / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003937:Diagnosis, Differential; D006801:Humans; D011014:Pneumonia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D011015:Pneumonia, Aspiration / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D009626:Terminology as Topic
chemical_list: D000900:Anti-Bacterial Agents
keywords: Anaerobic infection; Aspiration; Aspiration pneumonia; Lung abscess; Microbiology of pneumonia; Pneumonia