In suspected infection, what sequence should be followed regarding sample collection and antibiotic therapy?

• A. Start antibiotics first, then collect culture
• B. Collect culture, then start antibiotics
• C. Start antibiotics after culture results
• D. Do not culture

Answer: (B)

When infection is suspected, the important practice is to obtain cultures before starting antibiotics. Collecting the right samples first—the blood cultures and any site-specific specimens from the suspected infection (wound, urine, sputum, CSF, etc.)—maximizes the chances of identifying the exact organism and its antibiotic sensitivities. Antibiotics can reduce or eliminate the pathogen in the sample, making it harder to detect and delaying the ability to tailor therapy.

Once cultures are drawn, you can start antibiotics if the patient is ill or delaying treatment would worsen outcomes. If possible, wait for culture results to guide therapy so you can use a targeted, narrower regimen rather than broad-spectrum antibiotics. Do not culture nothing; obtaining specimens provides essential information for accurate diagnosis and effective, stewardship-minded treatment.