AUA 2018: Implementation of a Novel Point of Care PCR Test to Guide Antibiotic Prophylaxis Prior to Transrectal Prostate Biopsy
Rectal swabs were obtained 2-6 weeks prior to biopsy or the day of the biopsy. Two cultures were taken – one for culture for Ciprofloxacin infused agar and sensitivity testing. The second was for real-time PCR analysis. Techniques and results were compared.
140 men participated in this study, with pre-biopsy culturing guiding antibiotic usage in 102 patients. Men without pre-biopsy cultures were randomized to PCR based antibiotic result to physician’s antibiotic of choice. Cultures had a higher inadequate result compared to PCR (p<0.01). Pre-biopsy culture demonstrated an area under the curve of 0.91 compared to PCR of 0.71 (p=0.005). PCR had a false positive rate of 27% and missed 29% of fluoroquinolone resistance. Additionally, average clinic time was 67 minutes longer with the PCR test.
In summary, rapid PCR has a moderate ability to detect fluoroquinolone resistance patterns. Sepsis is caused by ST131:H30 in approximately 80% of cases. Liss stated that PCR time needs to be less than 20 minutes to keep the clinic running efficiently.
Presented by: Michael A. Liss, MD, University of Texas-San Antonio
Written by: David B. Cahn, DO, MBS Fox Chase Cancer Center Philadelphia, PA @dbcahn at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA