Do Emergency Department Blood Cultures Change Practice in Patients With Pneumonia?

Bacteraemia in outpatients with community-acquired pneumonia

“…However, there is little information regarding the prevalence and clinical impact of bacteraemia in CAP patients treated outside the hospital. Previous studies reported incidences of 2.1-7%, respectively [5][6][7][8]. However, few data exist regard predictive factors and the clinical outcomes associated with positive blood cultures in this population [8].…”

“…In our study, the prevalence of these cases was 7% of the total bacteraemic cases collected over 10 years. In a review of the literature, we found percentages that ranged between 2.1% and 7% [5][6][7][8]13].…”

“…BENENSON et al [8], in a retrospective study, found that oxygen saturation <90%, serum sodium <130 mg·dL −1 and respiratory rate >30 breaths per min were factors associated with a positive blood culture in a cohort of hospitalised patients with CAP. In another retrospective study [7] of 414 cases, positive blood cultures were identified in 7% of cases but no predictors were provided. In this study, antibiotic therapy was modified only in 15 (3.6%) cases with positive blood culture.…”

Randomised controlled trial and health economic evaluation of the impact of diagnostic testing for influenza, respiratory syncytial virus and Streptococcus pneumoniae infection on the management of acute admissions in the elderly and high-risk 18- to 64-year-olds

“…[111][112][113] Culturing blood before antibiotic therapy is recommended by the BTS (and similar bodies) for all hospitalised patients with moderate and high-severity CAP, but studies have suggested that blood cultures rarely alter antibiotic therapy for patients presenting with pneumonia because of the low overall positive rate of blood cultures. 112,[114][115][116][117][118] Moreover, clinicians did not follow protocols for narrowing an antibiotic spectrum even when appropriate. Sputum culture is often used to help identify aetiological agents and is recommended by BTS to investigate moderate severity CAP and severe CAP that fails to improve.…”

The Centers for Medicare and Medicaid Services (CMS) Community‐Acquired Pneumonia Core Measures Lead to Unnecessary Antibiotic Administration by Emergency Physicians

“…[7][8][9][10][11][12] The increased awareness of CAP core measures, with questionable recommendations on blood cultures and time limits, may have affected the practice of many emergency medicine (EM) practitioners. 12,13 In this study, emergency physician (EP) understanding of the CMS core measures for CAP guidelines was assessed. The survey respondents also were asked whether these guidelines had influenced their own antibiotic prescribing patterns related to this patient population.…”