In a patient with suspected bloodstream infection, take two sets of blood cultures and a urine culture where relevant before the first antibiotic dose, as long as this does not delay treatment by more than about an hour. In older adults, sepsis may present with confusion, falls or reduced intake rather than fever.
Once the culture result is back, narrow the antibiotic to the organism and its sensitivities, and record the intended duration at the first review.
- Take blood cultures before the first antibiotic dose when it will not delay treatment
- In older adults, confusion or a fall can be the presenting sign
- Send urine for culture when a urinary source is suspected
- Review the antibiotic when results return and record a stop date
Why it matters
Cultures taken afterwards often miss the organism that guides narrowing.
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