title: Utility of blood cultures in community-acquired pneumonia requiring hospitalization: influence of antibiotic treatment before admission.
abstract: It has been previously shown that antibiotics given before hospitalization significantly reduce the proportion of positive blood cultures in community-acquired pneumonia (CAP). The aim of this prospective study was to compare the utility and cost-benefits of blood cultures in patients, hospitalized for moderate CAP, who had or had not received antibiotic therapy prior to admission. During 1 year, 53 patients were included and separated into two groups: group 1 patients had not received antibiotic treatment prior to admission (n = 30), whereas group 2 patients had been treated with antibiotics (n = 23). Within the first 48 hours, a set of blood cultures was collected if the body temperature was higher than 38.5 degrees C or in the case of shaking chills. A total of 136 blood cultures was collected; 74 in group 1 and 62 in group 2. Bacteraemia was significantly more frequent in group 1 than in group 2, 5/30 patients vs. 0/23, respectively (P < 0.05). The cost of negative blood cultures was valued at 13,939.2 FF in group 1 and 13,164.8 FF in group 2, respectively 464.6 +/- 244.3 FF and 569.3 +/- 233.4 FF per patient (n.s.). Moreover, blood cultures were the method of diagnosis in only one of the five patients with bacteraemia and in no case did a positive blood-culture result influence the initial therapeutic regime. Thus, our results suggest a reduced clinical utility and cost-benefit of blood cultures in patients hospitalized for moderate CAP who have received an antibiotic treatment prior to admission.
authors.affiliation: Pneumology and Intensive Care Unit, Centre Hospitalier Universitaire Sud, Amiens, France.
authors.forename: J C
authors.initials: JC
authors.lastname: Glerant
authors.forename: D
authors.initials: D
authors.lastname: Hellmuth
authors.forename: J L
authors.initials: JL
authors.lastname: Schmit
authors.forename: J P
authors.initials: JP
authors.lastname: Ducroix
authors.forename: V
authors.initials: V
authors.lastname: Jounieaux
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000209:etiology; D001826:Body Fluids; D017714:Community-Acquired Infections / Q000188:drug therapy; D003362:Cost-Benefit Analysis; D006403:Hematologic Tests; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy*; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents