Eligible studies (any design) needed to evaluate and report changes in clinical management (antibiotic therapy, duration of parenteral therapy or length of stay in hospital) as a consequence of blood cultures taken at or near admission to hospital in adults who presented with community acquired infection.
Sample size, setting and exclusion criteria varied across studies. Most studies required that diagnosis of pneumonia was confirmed with a chest X-ray. Blood cultures were mandatory in four studies (one subgroup). Reported antibiotic regimens were predominantly cephalosporin plus macrolide or fluoroquinolones or penicillin/penicillin derivatives. Reported outcomes included blood culture directed antibiotic narrowing or broadening, percentage true and false positive blood cultures and duration of parenteral therapy.
Two reviewers independently assessed each selected full-text article for inclusion. Disagreements were resolved by discussion and with the aid of a third reviewer. However, the authors stated neither how the initial papers were selected for the review nor how many reviewers performed the initial selection of studies from titles and abstracts.