Low-Value Blood Culture Use in Adult Emergency Department Patients: A Scoping Review

Area of Science:

• Emergency Medicine
• Clinical Pathology
• Health Services Research

Background:

• Blood cultures (BCs) are vital for sepsis diagnosis in emergency departments (EDs).
• Inappropriate BC use leads to low-value care, causing harm and limited clinical benefit.
• Low-value blood cultures (LVBCs) persist despite recommendations for selective testing.

Purpose of the Study:

• To review the literature on LVBCs in adult ED patients.
• To identify definitions, contexts, drivers, and consequences of LVBCs.
• To highlight knowledge gaps in LVBC research.

Main Methods:

• Scoping review of six databases (inception to June 30, 2025).
• Inclusion of studies on adult ED patients and LVBC use.
• Data extraction and risk of bias assessment by two independent reviewers.

Main Results:

• 18 studies included; no consistent LVBC definition found.
• LVBC prevalence ranged from 19% to 69%.
• Key drivers included quality measure pressure; consequences involved unnecessary treatments and prolonged stays.

Conclusions:

• LVBCs are prevalent but inconsistently defined in adult EDs.
• Standardized criteria and root cause interventions are needed.
• Further research on patient-centered and economic outcomes is essential.