Routine blood cultures are commonly taken in patients who present to the Emergency Department (ED) with suspicion of infection. This is also in conjunction with treatment guidelines for severe community-acquired pneumonia, acute meningitis and bacteraemia, etc. The above practice has become a major area of resource utilisation, despite many studies showing poor yield of these cultures. The poor yield of blood cultures is financially costly for patients, and even more so for hospitals. Hidden costs such as wastage of resources, additional working hours for healthcare staff and increased needle stick injuries are a huge burden to hospitals. In addition, contamination (or false-positive blood culture results) has been shown to lead to increased length of stay and total hospital charges.
This review questions the efficacy of routine blood cultures taken in the emergency department, in the context of community-acquired pneumonia, cellulitis, urinary tract infection and pyelonephritis.
The results of the review showed that blood cultures for community acquired pneumonia, simple and complicated cellulitis as well as simple acute urinary tract infections are not recommended as they do not hold much significant clinical impact on the antibiotic regimen and there is no need for them to be taken prior to the administration of antibiotics. Blood cultures should be taken in patients with severe signs of systemic infection, hospital-acquired pneumonia, complicated cellulitis and pyelonephritis because it is possible for blood cultures to have a bearing on the clinical management.