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Routine blood culture in the emergency department: Worthy or waste?

Routine blood culture in the emergency department: Worthy or waste? The overuse of blood cultures for primary diagnosis has been recognized for more than three decades.1 The problem continues to exist and the reality is that less than 20% of blood cultures are true positives.2–4 Nevertheless, the blanket use in the emergency departments (EDs) persists as does the concern as to their usefulness, particularly when time and cost are considered. There is also controversy surrounding the necessity to perform blood cultures in cases of pneumonia and urinary tract infection (UTI), where sputum and urine cultures provide more direct and cost‐efficient diagnosis.As a Q.A. project for a suburban teaching hospital, we analyzed the efficacy of blood cultures in the ED and demonstrated, yet again, the extravagant overuse. In the course of two fall months, 829 cultures initiated in the ED were performed on 514 patients. Only 57 cultures were positive; fifteen of these, after obtaining further culture results, were determined to be false positives, leaving only 5.1% of the total (38 cultures) to be diagnostically worthwhile. Eleven patients had a positive culture for UTI and 22 had similar results for pneumonia. The remaining five had positive cultures for skin infection and four for endocarditis. Our findings of the predominance of http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Academic Emergency Medicine Wiley

Routine blood culture in the emergency department: Worthy or waste?

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References (11)

Publisher
Wiley
Copyright
Copyright © 2023 Society for Academic Emergency Medicine
ISSN
1069-6563
eISSN
1553-2712
DOI
10.1111/acem.14736
Publisher site
See Article on Publisher Site

Abstract

The overuse of blood cultures for primary diagnosis has been recognized for more than three decades.1 The problem continues to exist and the reality is that less than 20% of blood cultures are true positives.2–4 Nevertheless, the blanket use in the emergency departments (EDs) persists as does the concern as to their usefulness, particularly when time and cost are considered. There is also controversy surrounding the necessity to perform blood cultures in cases of pneumonia and urinary tract infection (UTI), where sputum and urine cultures provide more direct and cost‐efficient diagnosis.As a Q.A. project for a suburban teaching hospital, we analyzed the efficacy of blood cultures in the ED and demonstrated, yet again, the extravagant overuse. In the course of two fall months, 829 cultures initiated in the ED were performed on 514 patients. Only 57 cultures were positive; fifteen of these, after obtaining further culture results, were determined to be false positives, leaving only 5.1% of the total (38 cultures) to be diagnostically worthwhile. Eleven patients had a positive culture for UTI and 22 had similar results for pneumonia. The remaining five had positive cultures for skin infection and four for endocarditis. Our findings of the predominance of

Journal

Academic Emergency MedicineWiley

Published: Nov 1, 2023

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