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Research ArticleOriginal Contributions

Sputum Color: Potential Implications for Clinical Practice

Allen L Johnson, David F Hampson and Neil B Hampson
Respiratory Care April 2008, 53 (4) 450-454;
Allen L Johnson
The Polyclinic, Seattle, Washington
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David F Hampson
St Mary Medical Center, Walla Walla, Washington
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Neil B Hampson
Section of Pulmonary and Critical Care Medicine, Virginia Mason Medical Center, Seattle, Washington
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  • For correspondence: [email protected]
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Abstract

BACKGROUND: Respiratory infections with sputum production are a major reason for physician visits, diagnostic testing, and antibiotic prescription in the United States. We sought to determine whether the simple characteristic of sputum color provides information that impacts resource utilization such as laboratory testing and prescription of antibiotics.

METHODS: Out-patient sputum samples submitted to the microbiology laboratory for routine analysis were assigned to one of 8 color categories (green, yellow-green, rust, yellow, red, cream, white, and clear), based on a key made from paint chip color samples. Subsequent Gram stain and culture results were compared to sputum color.

RESULTS: Of 289 consecutive samples, 144 (50%) met standard Gram-stain criteria for being acceptable lower-respiratory-tract specimens. In the acceptable Gram-stain group, 60 samples had a predominant organism on Gram stain, and the culture yielded a consistent result in 42 samples (15% of the 289 total specimens). Yield at each level of analysis differed greatly by color. The yield from sputum colors green, yellow-green, yellow, and rust was much higher than the yield from cream, white, or clear.

CONCLUSIONS: If out-patient sputum is cream, white, or clear, the yield from bacteriologic analysis is extremely low. This information can reduce laboratory processing costs and help minimize unnecessary antibiotic prescription.

  • respiratory
  • infection
  • sputum color
  • antibiotics
  • laboratory
  • prescription
  • microbiology
  • Gram stain
  • predominant organism
  • bacteria

Footnotes

  • Correspondence: Neil B Hampson MD, Section of Pulmonary and Critical Care Medicine, Virginia Mason Medical Center, H4-CHM, 1100 Ninth Avenue, Seattle WA 98101. E-mail: neil.hampson{at}vmmc.org.
  • Copyright © 2008 by Daedalus Enterprises Inc.
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Respiratory Care: 53 (4)
Respiratory Care
Vol. 53, Issue 4
1 Apr 2008
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Sputum Color: Potential Implications for Clinical Practice
Allen L Johnson, David F Hampson, Neil B Hampson
Respiratory Care Apr 2008, 53 (4) 450-454;

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Sputum Color: Potential Implications for Clinical Practice
Allen L Johnson, David F Hampson, Neil B Hampson
Respiratory Care Apr 2008, 53 (4) 450-454;
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Keywords

  • respiratory
  • infection
  • sputum color
  • antibiotics
  • laboratory
  • prescription
  • microbiology
  • Gram stain
  • predominant organism
  • bacteria

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