Positive Predictive Value of Blood Cultures Utilized by Community Emergency Physicians

Objective. To determine the positive predictive value of blood cultures obtained from patients from a suburban ED and how the ED physicians use empirical antibiotics. Method. This retrospective chart review study was conducted at the ED of a suburban teaching hospital. The study consisted of adult patients who presented to the ED with evidence of clinical conditions suggesting bacteremia. Result. Over a 12-month period, 408 patients with positive blood cultures were drawn in the ED. The mean age of the patients was 65.85 years. The positive predictive value was 58.3%, and community ED physicians used appropriate empirical antibiotics in 72.3% of patients with true bacteremia. Conclusion. The positive predictive value indicated that many of the positive blood culture results were false positives from skin contamination. Blood cultures are necessary to follow up any positive results with more reliable tests to obtain a more accurate assessment as to whether bacteremia is present in the emergency department. True positive blood cultures can assist other doctors in adjusting the antibiotics. Emergency physicians overall used appropriate antibiotics in 72.3% of patients with true bacteremia. This study demonstrated that emergency physicians have the potential to improve the empirical treatment in treating patients.