Use and abuse of blood cultures: Program to limit use

Abstract

Many health care providers order an unnecessary number of blood cultures. We studied the ordering habits in our medical intensive care unit and recommended a protocol for appropriate ordering. Implementation of the protocol resulted in a significant reduction in the number of episodes of suspected sepsis, from 39% of patient discharges during the baseline period to 16% during the study period (p = 0.008). The mean number of blood cultures decreased significantly from 1.2 per patients discharged to 0.3 (p = 0.003). The number of episodes when more than four blood cultures were ordered decreased from 7 to 0, resulting in an annual cost savings estimated at $8025. The net benefit was reversed, however, when the protocol ceased to be actively implemented. We concluded that the appropriate ordering of blood cultures can be effected by establishing a protocol that is actively and continuously implemented.