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Teachable Moment
Less Is More
April 2015

Antibiotics “Just-In-Case” in a Patient With Aspiration Pneumonitis

Author Affiliations
  • 1Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 2Division of Internal Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 3Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada
  • 4Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
JAMA Intern Med. 2015;175(4):489-490. doi:10.1001/jamainternmed.2014.8030

A 50-year-old man with cerebral palsy presented to the emergency department with a witnessed generalized tonic-clonic seizure. He had a known seizure disorder that previously had been well controlled with valproate sodium. On transfer, he had multiple seizures, which eventually terminated with intravenous lorazepam in the emergency department. His blood pressure was 70/40 mm Hg, and his Glasgow Coma Scale was 6. He was intubated to protect his airway. A chest radiograph demonstrated extensive airspace opacities at the bases bilaterally, causing concern for aspiration, and he was started on treatment with piperacillin-tazobactam.

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