Blood culture use in the emergency department in patients hospitalized for community-acquired pneumonia

Makam AN, Auerbach AD, Steinman MA.
JAMA Intern Med. 2014 May;174(5):803-6.
University of Texas Southwestern Medical Center, Dallas, Texas

  • The proportion of cultures collected in the ED during these visits increased from 10% in 2002 to 20% in 2010.
  • The proportion of cultures collected in patients hospitalized with community-acquired pneumonia (CAP) increased from 29% in 2002 to 51% in 2010, a 76% relative increase.
  • One potential explanation for increasing culture rates is that the JCAHO/CMS core measure (PN-3b) announced in 2002 mandated that if a culture is collected in the ED, it should be collected prior to antibiotic administration. This encouraged providers to reflexively order cultures in all patients admitted with CAP for whom antibiotic administration is anticipated.

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