Early Antibiotics After Aspiration in ICU Patients

Inclusion Criteria: * Admitted to the ICU within the last 24 hours, or with a witnessed aspiration event in the last 24 hours while in the ICU * Radiographic findings on chest x-ray or CT deemed by the treating ICU team to be consistent with aspiration (e.g. dependent infiltrates or intraluminal airway debris) * Clinical history consistent with possible aspiration (e.g. cardiac arrest, found unconscious, or with a witnessed aspiration event). Exclusion Criteria: * Already received 3 or more doses of any antibiotic since hospital presentation, unless the last dose was greater than 1 week before enrollment * Requires antibiotic therapy for the treatment of other infections * Patient "comfort measures only" at time of screening * Currently participating in other trials using investigational drugs or interventions * Currently pregnant * Currently a prisoner * The consenting party (patient or their legally authorized representative) is unable to understand or read English at a fifth-grade level. * 2 or more of the following are present at the time of screening: * White blood cell count: ≥ 11.0 * Temperature ≥ 38.0C (100.4F) * Purulent secretions * S/F (pulse oximetry saturation to FiO2) ratio ≤ 215