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Aspiration PNA


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Curious as to what other PAs preferred treatment regimen is for aspiration PNA. I have used the typical coverage (levaquin or rocephin plus zithro) plus clinda and per ISDA guidelines but noticed others are following British Thoracic guidelines using flagyl instead of clindamycin. The main argument I hear is that clinda has high rate of C Diff. However the counter point is flagyl promotes VRE and is more neurotoxic. I know it's mostly opinion (unless some RCT or prospective trial exists that I'm unaware of?) but what are your all preferred regimens and why?

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