Anna Stevenson1, Phil Hider, Martin Than. 1. Clinical Decision Support Unit, Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand. phil.hider@chmeds.ac.nz
Abstract
AIM: To assess the utility of blood cultures in the management of patients presenting to the Emergency Department at Christchurch Hospital from the community with non-facial cellulitis (or soft tissue infection) and no other morbidity. METHODS: A multidisciplinary team formulated the search protocol. A systematic review methodology was used. Seven electronic databases were searched for clinical studies of blood culture utility in patients with non-facial cellulitis. Relevant studies were appraised using predetermined validity assessment criteria. Conclusions were presented based on an assessment of the validity and applicability of the evidence. RESULTS: Seventeen studies were identified as addressing the topic at least as part of a secondary objective for the study. All were retrospective reviews or case series and were often associated with significant methodological limitations. CONCLUSIONS: Blood cultures are rarely positive in patients presenting from the community with non-facial cellulitis. When they are positive, initial empiric therapy is usually adequate to treat pathogenic bacteria. The available evidence does not support the routine use of blood cultures in the clinical management of healthy adults presenting with non-facial cellulitis at the Emergency Department.
AIM: To assess the utility of blood cultures in the management of patients presenting to the Emergency Department at Christchurch Hospital from the community with non-facial cellulitis (or soft tissue infection) and no other morbidity. METHODS: A multidisciplinary team formulated the search protocol. A systematic review methodology was used. Seven electronic databases were searched for clinical studies of blood culture utility in patients with non-facial cellulitis. Relevant studies were appraised using predetermined validity assessment criteria. Conclusions were presented based on an assessment of the validity and applicability of the evidence. RESULTS: Seventeen studies were identified as addressing the topic at least as part of a secondary objective for the study. All were retrospective reviews or case series and were often associated with significant methodological limitations. CONCLUSIONS: Blood cultures are rarely positive in patients presenting from the community with non-facial cellulitis. When they are positive, initial empiric therapy is usually adequate to treat pathogenic bacteria. The available evidence does not support the routine use of blood cultures in the clinical management of healthy adults presenting with non-facial cellulitis at the Emergency Department.
Authors: K Wildi; S Tschudin-Sutter; S Dell-Kuster; R Frei; H C Bucher; R Nüesch Journal: Eur J Clin Microbiol Infect Dis Date: 2011-04-20 Impact factor: 3.267