title: Improving the use of sputum cultures in lower respiratory tract infection.
abstract: BACKGROUND
  The clinical value of sputum culture in suspected lower respiratory tract infection (LRTI) remains contentious. The quality of samples submitted significantly impacts their clinical usefulness.
  
  
  METHODS
  Using pre-defined criteria we prospectively analysed the appropriateness of sputum samples submitted from consecutive patients with suspected LRTI attending two acute hospital units over ten weeks. We then provided an education package for staff on when and how to collect appropriate sputum samples, and repeated the evaluation.
  
  
  RESULTS
  Our intervention reduced sample numbers from 347 to 133, simultaneously increasing the proportion of appropriately sent samples from 40.5 to 60.2% (p=0.001) and reducing cost. Appropriate sampling was associated with a higher yield of pathogens (relative risk 1.51, 95% confidence intervals 1.03-2.21, p=0.03). The rate at which sputum samples appeared to alter clinicians' management remained low and constant at 18% pre- and post-intervention.
  
  
  CONCLUSIONS
  A simple educational intervention can significantly increase appropriateness of sputum sampling, reducing workload and cost.
authors.affiliation: Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK.
authors.forename: O L
authors.initials: OL
authors.lastname: Moncayo-Nieto
authors.forename: P
authors.initials: P
authors.lastname: Reid
authors.forename: I F
authors.initials: IF
authors.lastname: Laurenson
authors.forename: A J
authors.initials: AJ
authors.lastname: Simpson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002983:Clinical Competence; D005260:Female; D006760:Hospitalization; D006801:Humans; D008168:Lung / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000382:microbiology; D013048:Specimen Handling / Q000592:standards*; D013183:Sputum / Q000382:microbiology*; D013663:Teaching / Q000379:methods*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Sputum culture; lower respiratory tract infection