Cost-effectiveness of blood cultures for adult patients with cellulitis.

Authors

Perl B, Gottehrer NP, Raveh D, et al. 

Institution

Infectious Diseases Unit, Shaare Zedek Medical Center, Jerusalem 91031, Israel.

Source

Clin Infect Dis 1999 Dec; 29(6) :1483-8.

Abstract

To assess the cost-effectiveness of blood cultures for patients with cellulitis, a retrospective review was conducted of clinical and microbiological data for all 757 patients admitted to a medical center because of community-acquired cellulitis during a 41-month period. Blood cultures were performed for 553 patients (73%); there were a total of 710 blood samples (i.e., a mean of 1.3 cultures were performed per patient). In only 11 cases (2.0%) was a significant patient-specific microbial strain isolated, mainly beta-hemolytic streptococci (8 patients [73%]). An organism that was considered a contaminant was isolated from an additional 20 culture bottles (3. 6%). The cost of laboratory workup of the 710 culture sets was $36, 050. Isolation of streptococci led to a change from empirical treatment with cefazolin to penicillin therapy for 8 patients. All patients recovered. In conclusion, the yield of blood cultures is very low, has a marginal impact on clinical management, and does not appear to be cost-effective for most patients with cellulitis.

Mesh

Adolescent
Adult
Aged
Aged, 80 and over
Bacteremia
Bacteria
Bacterial Infections
Bacteriological Techniques
Cellulitis
Clinical Laboratory Techniques
Cost-Benefit Analysis
Female
Humans
Male
Middle Aged
Retrospective Studies
Staphylococcus aureus
Streptococcus

Language

eng

Pub Type(s)

Journal Article

PubMed ID

10585800