Aspiration pneumonia: epidemiology, risk factors, etiology, diagnosis, treatment, prophylaxis, and prognosis




Clàudia Sitges-Milà, Internal Medicine Service, Hospital Universitari de Mataró, Consorci Sanitari Del Maresme, Mataró, Barcelona, Spain; Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; Grup d’Estudi al Maresme de la Pneumònia Adquirida a la Comunitat i la MPOC, Consorci Sanitari del Maresme, Barcelona, Spain
Ramon Boixeda Viu, Internal Medicine Service, Hospital Universitari de Mataró, Consorci Sanitari Del Maresme, Mataró, Barcelona, Spain; Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; Grup d’Estudi al Maresme de la Pneumònia Adquirida a la Comunitat i la MPOC, Consorci Sanitari del Maresme, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain
Jordi Almirall, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; Grup d’Estudi al Maresme de la Pneumònia Adquirida a la Comunitat i la MPOC, Consorci Sanitari del Maresme, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain; Intensive Care Unit, Hospital Universitari de Mataró, Consorci Sanitari Del Maresme, Barcelona, Spain


Aspiration pneumonia (AP) represents an increasing global health concern due to its high incidence and mortality, especially in ageing populations. This review explores AP’s definition, epidemiology, etiology, risk factors, diagnosis, treatment, prevention, and costs. This review was conducted through a comprehensive analysis of the existing AP literature. AP primarily affects elders and is closely linked to oropharyngeal dysphagia. Diagnosis requires clinical and radiological evaluation alongside risk factor assessment for oropharyngeal aspiration and oral bacterial colonization. Management is multidisciplinary, with guidelines discouraging routine anaerobic antibiotics. Prevention includes rehabilitation, oral care, vaccination, swallowing, and risk factor assessment. AP leads to poorer outcomes than non-AP, including higher recurrence, mortality, longer hospitalization, and increased healthcare costs. AP requires multimodal and multidisciplinary management, targeted antibiotics, and non-pharmacological prevention. Further research is essential to optimize treatment and prevention.