Dear SSC,

What is the SSC guideline for whether to draw a blood culture on an inpatient 
who develops severe sepsis during the admission who has already been receiving 
broadspectrum IV antibiotic? This question is for both a first time BC and for 
a patient who had a BC done previously.  It is my understanding that when a 
patient develops new severe sepsis we are to follow the complete 3hour bundle 
regardless of whether he or she is already on IV antibiotics or whether a BC 
has been done already.

The repeat BC question came up during our case review today.  I see in a brief 
online lit review, ...BC repeats account for one-third of all BCs handled in 
the laboratory, with little additional yield. Guidelines for repeating BCs may 
decrease unnecessary testing." Clin Microbiol Infect 2004; 10: 624-627.  Are 
repeat blood cultures that are performed outside of the 3 hour bundle time not 
considered a fallout?

Thank you in advance for your guidance and any recommended references.


Regards,

Kathleen Biederman, RN, MS
Patient Quality & Safety Specialist
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