GRAMS STAIN AND CULTURE OF SPUTUM IN THE ROUTINE MANAGEMENT OF PULMONARY INFECTION

Gram's stain (GS) and culture of sputum are used routinely for diagnos is of lung infection. We prospectively studied physicians' use of sput um GS and culture for management of lung infection, the correlation be tween GS and culture in 224 adequate sputum specimens from patients ad mitted to our hospital over a 15-month period, and its impact on the a ntibiotic used. GS correlated with sputum culture in one third of the cases in the most predictive group. Gram-negative rods including Haemo philus influenzae formed the majority of the positive cultures and wer e also the most poorly predicted by GS. Physicians used broad spectrum antibiotics empirically in most cases. These choices were not altered by the culture results in the most instances. It may be reasonable to use broad spectrum antibiotics empirically for lung infection. Sputum GS and culture may be helpful in patients at risk for high morbidity and mortality.