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Current guideline recommendations call for obtaining blood cultures as part of the initial evaluation of moderately to severely ill children hospitalized with community-acquired pneumonia (CAP). However, blood cultures are positive in only a small percentage (well below 10%) of children with pneumonia.
To compare clinical and cost outcomes of strategies of universal culturing of all patients versus targeted culturing of patients at high risk for bacteremia in this setting, researchers developed a decision-analysis model that incorporated the predicted rates of bacteremia in CAP (3.5%) and blood culture contamination (1.4%), the proportion of positive cultures expected to result in an antibiotic change (38%), and the estimated proportion of h…