title: Should all children admitted with community acquired pneumonia have blood cultures taken?
abstract: OBJECTIVE
  To evaluate the yield of blood cultures and the impact of blood culture results on the adjustment of empiric antibiotic treatment in children hospitalised with community acquired pneumonia (CAP).
  
  
  METHODS
  This was a prospective study conducted at a tertiary hospital in Malaysia, from 1st August 2010 until 31st July 2011. Children aged between 1 mo and 12 y who were admitted for CAP and had blood cultures performed before starting intravenous antibiotics were recruited. Children with congenital pneumonia, immunodeficiency, chronic cardiac or respiratory disorders, nosocomial pneumonia or those on corticosteroids, were excluded. Decision for admission was made by the attending Accident and Emergency physician.
  
  
  RESULTS
  One hundred and seventy-one children were enrolled. The median age was 13 mo (range: 38 d-10 y 3 mo) and 59 % were males. Blood cultures were positive in 1.2 % (2/171) of patients while the contamination rate was 1.8 % (3/171). Doctors altered antibiotics based on blood culture results in only one patient.
  
  
  CONCLUSIONS
  Both the yield and the impact of blood culture results on the adjustment of empiric antibiotic treatment were very small. There was a high contamination rate. The recommended practice of performing blood cultures in all children admitted with CAP should be reviewed.
authors.affiliation: Department of Pediatrics, University Malaya, 50603, Kuala Lumpur, Malaysia.
authors.forename: Eng Meng
authors.initials: EM
authors.lastname: Lai
authors.forename: Anna Marie
authors.initials: AM
authors.lastname: Nathan
authors.forename: Jessie A
authors.initials: JA
authors.lastname: de Bruyne
authors.forename: Lee Lee
authors.initials: LL
authors.lastname: Chan
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000097:blood / Q000188:drug therapy / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000097:blood / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008296:Malaysia; D008297:Male; D018410:Pneumonia, Bacterial / Q000097:blood / Q000188:drug therapy / Q000382:microbiology*; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents