Adult patients in the emergency department with sepsis or suspected serious infection: Which patients should have blood cultures ordered?

Too much controversy continues to surround the issue of ordering blood cultures in the emergency department (ED). The key question of which of our ED patients should have blood extracted remains unresolved. Nor is there clear consensus. Against this background it is still crucial to identify patients at risk of true bacteremia, as untreated bacteremia can lead to more serious life-threatening events such as septic shock. The main purpose of this narrative review was to look at the evidence on ED treatment of adults with suspected sepsis or serious infection in an attempt to define when cultures should be ordered, given that the results of microbiology can have an impact on prognosis, progression, and mortality. The authors report their consensus on recommendations for ordering cultures in cases of serious infection or sepsis attended in EDs.