Aspiration after overdosage of sedative or hypnotic drugs

We have reviewed the charts of 329 patients admitted to our hospital because of overdosage from sedative or hypnotic agents. Of this population 11.2% were believed to have aspirated. Included in this group were 13 patients who were observed to aspirate and 24 who were suspected of aspiration because of the appearance of radiographic infiltrates associated with compatible microbiologic studies. In the observed group, seven became febrile, four were hypotensive, eight had radiographic infiltrates, three had complications, and one died. In the group suspected of aspiration, 23 became febrile, ten became hypotensive, five had complications, and none died. We believe the low mortality from aspiration in this setting justifies caution in the use of steroids and antibiotics.