Positive blood cultures can occur with or without an identifiable source
This section provides direction for the management of positive blood cultures, including Gram stain interpretation and empiric treatment of common pathogens
Do not narrow antibiotics until identity +/- susceptibilities are available
Guideline originally sourced from Markham Stouffville Hospital and adapted by Joseph Brant Hospital
Doern GV, Carroll KC, Diekema DJ, et al. A Comprehensive Update on the Problem of Blood Culture Contamination and a Discussion of Methods for Addressing the Problem. Clin Microbiol Rev. 2019;33(1):e00009-19. Published 2019 Oct 30.
Pien BC, Sundaram P, Raoof N, et al. The clinical and prognostic importance of positive blood cultures in adults. Am J Med. 2010;123(9):819-828.
Yahav D, Franceschini E, Koppel F, et al. Seven Versus 14 Days of Antibiotic Therapy for Uncomplicated Gram-negative Bacteremia: A Noninferiority Randomized Controlled Trial. Clin Infect Dis. 2019;69(7):1091-1098.
Punjabi C, Tien V, Meng L, Deresinski S, Holubar M. Oral Fluoroquinolone or Trimethoprim-sulfamethoxazole vs. ß-lactams as Step-Down Therapy for Enterobacteriaceae Bacteremia: Systematic Review and Meta-analysis [published online ahead of print, 2019 Aug 14]. Open Forum Infect Dis. 2019;6(10):ofz364.
The Johns Hopkins University (2020) John Hopkins ABX Guide (1.27) [Mobile App] Retrieved from: www.hopkinsguides.com
Antimicrobial Therapy Inc (2020) The Sanford Guide (4.2) [Mobile App] Retrieved from: www.sanfordguide.com/
Approved: June 2020