Aim: This controlled prospective study aims to investigate the possible effects of antibiotic treatment on prostate specific antigen (PSA) and its derivatives, and consequently on the transrectal biopsy rates, in the diagnosis of prostate cancer.
Patients and Methods: 140 patients between 45 and 70 years old, with a PSA level between 2.5 and 10 ng/ml and normal digital rectal examinations (DRE), were included in this study between June 2009 and November 2010. The patients were randomly assigned into two groups. The first group received levofloxacin 500 mg (p.o.) 1*1 for 21 days; the second, the control group, was given no treatment. Initially, total PSA (tPSA), free PSA (fPSA), a DRE, urinary ultrasonography (including prostate volume, post voiding residual urine), uroflowmetry, International Prostate Symptom Score (IPSS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and International Index of Erectile Function (IIEF) tests were performed. All of these were repeated at the end of three weeks of antibiotic treatment. An additional PSA measurement was also done at 10th day of the treatment. All patients underwent transrectal ultrasonography (TRUS) guided prostate biopsy at 21st day.
Results: The mean age of the patients was 59.6. Overall in 23 patients, prostate cancer was detected. Statistically, there were significant changes in values of PSA and its derivatives in the treatment group (from 5,31 to 4,69 and 4.58 ng/ml,). However, focusing on prostate cancer patients in both, the treatment and control, groups; we did not detect any significant change in the same parameters.
Conclusion: Antibiotic treatment given to the patients with a PSA level between 2.5 and 10 ng/ml can be beneficial, prior to a decision for TRUS guided prostate biopsy, just in a limited subgroup. However, considering the large population of patients in the gray zone, it still does not provide clear solid evidence for avoiding unnecessary prostate biopsies.
Written by:
Toktas G, Demiray M, Erkan E, Kocaaslan R, Yucetas U, Unluer SE. Are you the author?
e2-5 blok no 69 5 kisim atakoy, istanbul, Turkey, 34158, Istanbul Teaching and Training Hospital, urology, Nafiz Gurman Caddesi, Sanmatya Fatih, Istanbul, Turkey.
Reference: J Endourol. 2013 May 5. Epub ahead of print.
doi: 10.1089/end.2013.0022
PubMed Abstract
PMID: 23641793
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