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We examined the sensitivity of several BACTEC® media options for the detection of bacteremia and fungemia in children at two pediatric health care facilities. At one institution a single aerobic bottle containing PEDS Plus® medium was as sensitive in identifying positive blood cultures as the combination of aerobic and anaerobic media (77% vs. 80%; P = 1.0). When data from both facilities were combined, a blood culture set containing both aerobic and anaerobic media detected significantly more positive blood cultures than any single aerobic medium. However, the aerobic/anaerobic bottle combination was not significantly better than a blood culture set containing two aerobic media and, in absolute terms, the latter identified more cases of bacteremia. Of the 116 clinically significant episodes of bacteremia identified in this study, only 1 was caused by an anaerobic bacterium. We conclude that the routine use of anaerobic media for blood cultures of pediatric patients might be unnecessary but that the use of two different aerobic media could increase the sensitivity of the BACTEC® blood culture system.