Antibiotic Awareness Week (18th-24th November) is part of a global initiative to raise awareness of antibiotic resistance and promote the responsible use of antibiotics: ‘No action today, no cure tomorrow’.
Each day this week we will be bringing you an Antibiotic Awareness Message of the Day.
Today’s message: Obtain cultures before starting therapy
Quiz question 1.
Which of the following samples are useful to send to the microbiology lab?
A. A swab of pus
B. A slide of pus
C. A bucket of pus
D. A blood culture taken before antibiotics
E. A blood culture taken after antibiotics
F. Fresh tissue
G. Tissue in saline
H. Tissue in formalin
* Always collect specimens to confirm infection, preferably before antibiotics are commenced, as antibiotics decrease the yield of culture significantly. Blood, urine, nose/throat and wound swabs and tissue specimens may verify your clinical diagnosis and provide antibiotic susceptibility results to target specific organisms.
* Identifying a viral aetiology may reduce the need for antibiotics. Viral infections do not require antibiotics unless a secondary bacterial infection is suspected.
* Drain pus collections to hasten recovery and send the pus to the Microbiology Laboratory for culture.
* Don’t put tissue specimens for bacterial culture in formalin (yes, it happens frequently).
* Further information is available from the Pathology Specimen Collection resource: http://ww2.rch.org.au/specimen/
Answer: All except H.
A. A swab of pus – yes, but if you have more, send more
B. A slide of pus – yes always, as it allows a Gram stain which can help identification
C. A bucket of pus – yes yes yes
D. A blood culture before antibiotics – the ideal situation
E. A blood culture after antibiotics – still worth sending as organisms may be persistent or resistant
F. Fresh tissue – the ideal sample
G. Tissue in saline – only if the sample is very small and might dry out
H. Tissue in formalin – no, never!
On behalf of the RCH Antimicrobial Stewardship Committee (Penelope Bryant (chair), Andrew Daley, Nigel Curtis, Antun Bogovic, Mike South, Mike Starr, Sharon Smith, Jonathan Burge) http://www.nps.org.au/about-us/what-we-do/campaigns-events/antibiotic-resistance-fighter