Nonvalue of the initial microbiological studies in the management of nonsevere community-acquired pneumonia.

Abstract

STUDY OBJECTIVE: To assess the value of the initial microbiological studies (MBS), consisting of sputum Gram's stains, sputum cultures, and blood cultures, in the etiologic diagnosis of community-acquired pneumonia (CAP) without comorbidity. DESIGN: A prospective study of 74 adult patients hospitalized with nonsevere CAP empirically treated according to the American Thoracic Society guidelines (ATS-GL) and evaluated with Gram's stains and cultures of valid sputum specimens and blood cultures. SETTING: University-affiliated community hospital. RESULTS: Gram's stain of a valid sputum specimen failed to identify the etiologic agent in all patients. Sputum cultures identified pathogens in only four patients (5%). The results of all blood cultures were negative. All patients responded to the initial empiric antibiotic coverage selected according to the ATS-GL, and the results of the initial MBS had no clinical impact. CONCLUSION: The initial MBS, such as sputum Gram's stains, sputum cultures, and blood cultures, have no value in the management of nonsevere CAP without comorbid factors.