Do peripheral blood cultures taken in the emergency department influence clinical management?

Background: Blood cultures are routinely used to investigate suspected sepsis in the emergency department despite several studies demonstrating their limited influence on patient management. Objectives: To quantify the use and clinical relevance of blood cultures obtained in the emergency department. Methods: A retrospective study of blood cultures taken in the emergency department between 1 January 2003 and 31 December 2004. Microbiology results and patient records were reviewed to determine the influence of positive cultures on subsequent patient management. Results: 2213 blood cultures were taken in the emergency department over the study period. 132 (6%) yielded a positive result. Three positive cultures cases had incomplete information. Of the remaining 129 positive cultures, 30 (1.4% of all cultures) were true positives'' and 4 (0.18%) influenced subsequent patient management. Conclusions: Blood cultures taken in our emergency department rarely yield bacterial growth and over 2 years, only four seemed to directly influence patient management. Better guidelines are required for targeted use of blood cultures in the emergency department.