The reduction in blood culture rates over a two-year period among 14 pediatric intensive care units (PICU) across the country that participated in a Johns Hopkins Children’s Center-led collaborative aimed at reducing unnecessary blood draws among the most critically ill young patients in the hospital.

While ordering routine blood draws is an important part of making a diagnosis, unnecessary draws can lead to antibiotic overuse (contributing to antibiotic resistance), prolonged hospital stays and inflated health care costs, notes Aaron Milstone, a pediatric infectious diseases specialist at Johns Hopkins Children’s Center, and a leader of the BrighT STAR Collaborative (Testing STewardship to reduce Antibiotic Resistance), which ran from 2017–2020.

Each participating PICU developed an implementation plan and created a unique clinical decision support tool to guide blood culture practice. During the project period, sites demonstrated a 33% reduction in blood culture rates and a 13% reduction in antibiotic use.

Milstone and colleagues initiated a follow-up study 24 months after the formal project period to determine whether participating sites sustained the reduced blood draw rates. Their findings, published in September in JAMA Pediatrics, show that the collaborative’s efforts continued to successfully reduce blood culture rates.