JAMA · 1991 · 549 citations · 13 references
PharmacyInfectious DiseasesPharmacoeconomicsDiagnostic MicrobiologyMedical MicrobiologyResource Utilization AnalysisBacteremia ManagementBloodstream Infection DiagnosticsDiagnostic StewardshipHealthcare-associated Infection PreventionHospital Antimicrobial StewardshipMicrobial ContaminationAntibiotic Utilization MeasurementAntimicrobial Utilization EvaluationBacteremia ScreeningChargesHospital Antimicrobial UtilizationPatient Resource UtilizationPharmacy Resource UtilizationResource Utilization Prediction
To determine whether contaminant blood cultures increase resource utilization, we studied charge and length of stay data for episodes in which blood cultures were obtained from hospitalized adults. Compared with 1097 negative episodes, 94 false-positive episodes were associated with increased subsequent length of stay (median, 12.5 vs 8 days) and subsequent total charges (median, $13,116 vs $8731), pharmacy charges (median, $1456 vs $798), and laboratory charges (median, $2057 vs $1426). In multivariate analyses, contaminants were independently correlated with 20% and 39% increases in total subsequent laboratory charges and intravenous antibiotic charges, respectively. Thus, the true costs of contaminants may greatly exceed those of the test itself. Identifying patients at very low risk of bacteremia and attention to sterile technique may reduce costs by decreasing the frequency of contaminants.
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William R. McCabe · Archives of Internal Medicine · 1962 · 1.4K citations
Melvin P. Weinstein, L. Barth Reller, James R. Murphy et al. · Clinical Infectious Diseases · 1983 · 754 citations
Predicting Bacteremia in Hospitalized Patients
David W. Bates · Annals of Internal Medicine · 1990 · 271 citations
Evaluation of Positive Blood Cultures
Rob Roy MacGregor · Archives of Internal Medicine · 1972 · 222 citations