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The contribution of blood cultures to the clinical management
of adult patients admitted to the hospital with community-acquired pneumonia:
a prospective observational study.
Autor – Campbell SG; Marrie
TJ; Anstey R; Dickinson G; Ackroyd-Stolarz S
Zeitschrift/Erscheinungsdatum –
Chest 2003 Apr;123(4):1142-50.
STUDY OBJECTIVES:
To assess the clinical usefulness of blood cultures (BCs) in the management
of patients hospitalized with community-acquired pneumonia (CAP). DESIGN:
A prospective, observational study to investigate the contribution of
BCs to the management and outcomes of adult patients presenting with CAP.
SETTING: Nineteen Canadian hospitals. PATIENTS: Adults admitted to the
hospital with CAP between January 1, 1998, and July 31, 1998. INTERVENTIONS:
The courses of therapy in patients for whom BC results yielded organisms
considered to be clinically significant were analyzed to determine whether
the BCs had contributed to management or outcome. MEASUREMENTS AND RESULTS:
Forty-three of 760 patients had significantly positive BC results. Patients
with CAP who had BCs performed had a 1.97% chance (15 of 760 patients)
of having a change of therapy directed by BC results. Patients in whom
BCs yielded positive results had a 34.8% chance (15 of 43 patients) of
having a change in therapy determined by BC results, and had a 58.1% chance
(25 of 43 patients) of having a course of therapy contraindicated by BC
results. Severity of illness, as measured by the pneumonia severity index,
correlated poorly with the yield of BCs. BC results were positive in 8.0%
of patients in risk classes I and II, 6.2% of patients in risk class III,
4.6% of patients in risk class IV, and 5.2% of patients in risk class
V. CONCLUSION: BCs have limited usefulness in the routine management of
patients admitted to the hospital with uncomplicated CAP.
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