Before initiating broad-spectrum antibiotics, which step should be performed?

• A. Urinalysis
• B. Blood culture and sensitivity
• C. Chest X-ray
• D. CBC

Answer: (B)

Obtaining blood cultures before starting broad-spectrum antibiotics is essential because it helps identify the causative organism and its antibiotic susceptibility. This information guides choosing the most effective targeted therapy and allows later de-escalation to narrower antibiotics, which reduces unnecessary exposure and helps combat resistance. If antibiotics are given before cultures, the results can be harder to interpret and may lead to inappropriate or overly broad therapy. Other tests like urinalysis, chest X-ray, or a CBC contribute to diagnosis and assessment but do not provide the specific organism and susceptibility data needed to tailor treatment.