Shehla Baqi, Geraldine Siviglia, Trevor Mclean, Harpreet Singh, Youn S Kim, Ruth P Berger, Anita Soni.
Management of positive blood cultures at a city hospital in New York.
Infect Dis J Jan ;16(2):39-44.

We prospectively evaluated antimicrobial therapy in 205 episodes of positive blood cultures involving 85 patients admitted to the Medical Floors over a 6 month period. Of 205, 88 were contaminants and 117 episodes were true/probable bacteremias. Assessment of antimicrobial therapy for bacteremias revealed that 71/98 (72%) empirical antibiotics were appropriate; 80/108 (76%) antibiotics after gram stain were appropriate and 72/103 (70%) antibiotics after susceptibility results were appropriate Inappropriate antimicrobial therapy was most often due to incorrect dosing for renal function and severity of infection as well as with regard to combination used and susceptibility profile. Of 88 contaminants, 20 (23%) were treated after gram stain result and 10 (11.4%) were treated after identification of the organism. Vancomycin was used in 60 of 205 (29%) episodes and was inappropriate in 19 of 60 (32%). This study underscores the need for continued education of physicians in the field of antimicrobial therapy.

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