NA;It is common practice to obtain cultures in the first 24 hours after burn injuries. However, little evidence exists that these tests change clinical practice or clinical outcome. We conducted a retrospective chart review to determine how often the results of wound and other cultures lead to changes in the clinical treatment of patients. A total of 598 charts were reviewed. Four hundred fortyhyphen;seven patients had a length of stay in the hospital of 1 day or less and were primarily treated in the emergency department and then discharged from the hospital. Wound cultures were obtained for 42 lpar;10percnt;rpar; of these patients. Thirty cultures lpar;71percnt;rpar; had no significant growth. Twelve cultures lpar;29percnt;rpar; grew mixed common skin flora. No patients in this group were ldquo;panhyphen;cultured.rdquo; No patients in this group required antibiotic treatment on the basis of culture results. A total of 151 patients were admitted to the burn center, with an average length of stay of 3.9 days lpar;range, 2hyphen;125 daysrpar;. In this group, 45 patients lpar;30percnt;rpar; had wound cultures and 24 patients lpar;16percnt;rpar; were panhyphen;cultured in the first 24 hours after admission to the hospital.Enterococcusspecies grew in the initial wound culture of 1 patient, and the patient was treated with antibiotics. Antibiotics were not ordered for any other patients on the basis of cultures. The collection of routine cultures during the first 24 hours after admission to the hospital is not costhyphen;effective and rarely alters or provides therapeutic direction. An estimated dollar;14,000 per year decrease in charges could be achieved by the elimination of cultures taken during the first 24 hours of admission to the hospital. lpar;J Burn Care Rehabil 2000semi;21colon;300hyphen;3rpar;
展开▼
