The impact of prebiopsy antibiotics on pathogen recovery in hematogenous XXXX .

@entity1 @entity4034 @entity425
BACKGROUND: Biopsy specimens are often obtained in the evaluation of hematogenous @entity4034 . The effect of prebiopsy antibiotic exposure on pathogen recovery is unknown. METHODS: We conducted a retrospective cohort study of adult inpatients with hematogenous @entity4034 at a tertiary care hospital from 1 January 2003 through 31 July 2007. Antibiotic exposure within 14 days before biopsy was evaluated. RESULTS: Of 150 @entity1 with hematogenous @entity4034 , 92 (61%) underwent a biopsy (60 [65%] needle and 32 [35%] open biopsies). The median time from admission to biopsy was 3 days (range, 0-69 days). @entity1 who underwent biopsy were more likely to have @entity425 (53 [58%] biopsy vs 15 [26%] no biopsy; P<.001) and sensory loss (27 [29%] vs 6 [10%]; P=.006), but were less likely to have a positive blood culture result (28 [30%] vs 30 [52%]; P=.01). Pathogens were recovered in 61 @entity1 (66%). Open biopsy had a higher yield than needle biopsy (29 [91%] of 32 vs 32 [53%] of 60; P<.001). Sixty @entity1 (65%) who had biopsies performed received antibiotics  <=14 days before the procedure (median duration, 4 days; range, 1-37 days). Open biopsy predicted positive biopsy culture results (adjusted odds ratio, 8.4; 95% confidence interval, 2.2-31.8), but there was no association of prebiopsy antibiotics with culture results (adjusted odds ratio, 2.3; 95% confidence interval, 0.8-6.2). CONCLUSIONS: A pathogen was recovered from 61 (66%) of 92 @entity1 who had biopsies performed in this cohort of hematogenous @entity4034 . Open biopsies had a higher microbiological yield than did needle biopsies. Antibiotic exposure before biopsy did not negatively impact pathogen recovery and should not be the sole reason for foregoing biopsies.
