title: The value of routine microbial investigation in community-acquired pneumonia.
abstract: The way in which microbiological investigations are used in routine clinical practice and the value of such tests in directing antibiotic prescribing, was studied in adults admitted to hospital with a diagnosis of community-acquired pneumonia. One-hundred and twenty-two consecutive patients admitted to one teaching and one district general hospital were studied between April 1988 and March 1989. Blood cultures were performed in 81% of cases, sputum was examined in 45% and complete serological tests were performed in 28%. No causative pathogen was found in 74% of cases and results of microbial tests directed a change in antibiotic therapy in only 8% of cases. Routine microbial investigation of all adults admitted to hospital with community-acquired pneumonia is unhelpful and probably unnecessary. We suggest a strategy for microbial investigation linked to initial illness severity to replace the current haphazard approach.
authors.affiliation: St George's Hospital, London, U.K.
authors.forename: M A
authors.initials: MA
authors.lastname: Woodhead
authors.forename: J
authors.initials: J
authors.lastname: Arrowsmith
authors.forename: R
authors.initials: R
authors.lastname: Chamberlain-Webber
authors.forename: S
authors.initials: S
authors.lastname: Wooding
authors.forename: I
authors.initials: I
authors.lastname: Williams
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006767:Hospitals, District; D006769:Hospitals, General; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D011014:Pneumonia / Q000188:drug therapy / Q000382:microbiology*; D012703:Serotyping; D013183:Sputum / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents