University of Wisconsin–Madison Medical College of Wisconsin

Improving Utilization of Sputum Culture in Patients Hospitalized with Pneumonia: A Quality Improvement Initiative

Catherine S. Taghizadeh, BS; Jennifer Zimmerman, DO; Faran Ahmad, MD; Richard Swaney, DO; Alexander Hall, PhD; Jeffrey Macaraeg, MD; Jennifer Anthone, PharmD; Manasa Velagapudi, MBBS

WMJ. 2026;125(3):391-393. Published August 11, 2026.

Download full-text pdf.

ABSTRACT

Background: Sputum cultures are essential for guiding targeted antibiotic therapy; however, they are often underutilized. This quality improvement initiative aimed to enhance sputum culture ordering through an antimicrobial stewardship pharmacist-led intervention.

Methods: A retrospective review of pneumonia hospitalizations from January 2021 through December 2022 evaluated the impact of a policy change allowing antimicrobial stewardship pharmacists to order sputum cultures. Statistical analyses compared preintervention and postintervention sputum culture ordering rates, adjusting for patient demographics, hospital admission location, and other covariates.

Results: Sputum culture orders increased from 36% before the intervention to 50% after the intervention, with a 29% higher likelihood of sputum culture ordering after the intervention (risk ratio, 1.29; 95% CI, 1.19–1.38; P < .001).

Conclusions: This intervention demonstrates the potential for antimicrobial stewardship programs to improve adherence to guideline-based practices through pharmacist-led initiatives.


Author affiliations: Creighton University School of Medicine, Phoenix, Arizona (Taghizadeh); Department of Internal Medicine, Creighton University School of Medicine, Omaha, Nebraska (Ahmad, Macaraeg, Swaney, Velagapudi, Zimmerman); Department of Clinical Research and Public Health, Creighton University, Omaha, Nebraska (Hall); Creighton University Medical Center at Bergan Mercy, Omaha, Nebraska (Anthone).
Corresponding author:
Catherine Taghizadeh; email CST40631@creighton.edu; ORCID ID 0009-0004-3522-6074
Financial disclosures: None declared.
Funding/support:
None declared.

Share WMJ