Check out www.postgradmed.com/issues/1999/04_99/farber.htm
Several questions. What happens if the patient has prior treatment
with antibiotics? Almost a third of admitted patients to hospitals
have had prior treatment with antibiotics. Sputum results during a
course of antibiotics are completely worthless. Diagnosis by sputum
depends too much on an experianced microbiologist, and many
laboratories routinely fail proficiency tests of common pathogens like
S. pneumoniae. How would these labs fair when dealing with the flora
found in sputum. New technology such as the Binax NOW antigen test,
which uses patient urine to diagnose S. pneumoniae is far more accurate
and take minutes rather than days or hours. Prior treatment does not
effect the diagnosis.
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