Antimicrobial Therapy for Asymptomatic Patients with Elevated Prostate-Specific Antigen: Can the Change in Prostate-Specific Antigen Reliably Guide Prostate Biopsy Decisions?

作者：Torky Mohammed; Mosharafa Ashraf^*; Emran Ashraf; Kamal Ayman; Abdelhamid Mohammed

来源：Urologia Internationalis, 2011, 87(4): 416-419.

DOI：10.1159/000331706

• Prostatitis
• Prostate-specific antigen
• Prostatic neoplasms
• Biopsy, needle

Objectives: To assess the effects of a 4-week levofloxacin course on PSA in asymptomatic men with elevated prostate-specific antigen (PSA) and on prostate biopsy decision. Methods: Fifty asymptomatic men with elevated PSA (4.0-10.0 ng/dl) were given levofloxacin 500 mg/day for 4 weeks followed by repeat PSA. Prostate biopsy was recommended at the end of the study. We compared pre-and post-treatment PSA as well as PSA changes between prostate cancer cases and non-cancer patients. Results: Mean (+/- SD) PSA decreased from 6.91 +/- 2.13 to 6.05 +/- 3.0 ng/dl after antimicrobial treatment (p = 0.025). Twenty-five (56.8%) patients had a post-treatment decrease in PSA, including 20 (45.5%) patients to <4.0 ng/dl and/or >25% of the initial PSA value. The difference in PSA change between prostate cancer and non-cancer patients was not statistically significant (p = 0.104). Conclusions: Levofloxacin resulted in an overall decrease in PSA for asymptomatic men with PSA in the 4-10 ng/dl range. PSA changes, however, were not significantly different between patients with prostate cancer and non-cancer patients. Prostate cancer was detected in 20% of patients with a clinically relevant PSA decline.

• 出版日期2011