Would you consider using steroids in patients with respiratory failure caused by aspiration pneumonitis?

For aspiration pneumonitis alone, typically no.

If there are other indications for steroids, for example, acute COPD or asthma exacerbation, then I would.

I would also focus on addressing the aspiration to prevent future events.

I have also seen providers use antibiotics if aspiration pneumonia vers...

There is no evidence supporting its use in this context, and there is plenty of evidence of potential complications. I have never used steroids in this setting, though I have used them in community-acquired pneumonia (CAP), for which the evidence is not applicable to aspiration pneumonia (PNA).

Antibiotics yes. Steroids, only if there is a reason to treat significant inflammation. Literature doesn't support routine use of steroids in this situation. However, I have found that ER physicians and hospitalists tend not only to use steroids pretty loosely, but also very high cringeworthy doses.