PSA reduction (after antibiotics) permits to avoid or postpone prostate biopsy in selected patients.
Microscopic foci of prostatitis may induce prostate-specific antigen (PSA) increase. PSA reduction after antibiotics might identify those patients in whom biopsy can be avoided. Ninety-nine patients received ciprofloxacin for 3 weeks, of whom 59 showed PSA reduction. Histology detected small foci of prostatitis in 65% of cases. Carcinoma was found in 40 and 20.3% of patients with unchanged or decreased PSA, respectively (P=0.03). No cancer was detected if PSA decreased below 4 ng/ml or more than 70%. Biopsy can be postponed, with a low risk of missing a cancer, if PSA decreases more than 70% or below 4 ng/ml.
Serretta
V
V
Department of Internal Medicine, Cardiovascular and Nephro-Urological Diseases, Institute of Urology, University of Palermo, Palermo, Italy. vserretta@libero.it
Catanese
A
A
Daricello
G
G
Liotta
R
R
Allegro
R
R
Martorana
A
A
Aragona
F
F
Melloni
D
D
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001707:Biopsy, Needle; D002939:Ciprofloxacin / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010173:Palpation; D018579:Patient Selection; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology; D011472:Prostatitis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D012306:Risk; D013997:Time Factors; D018084:Ultrasonography, Interventional; D019564:Unnecessary Procedures
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D017430:Prostate-Specific Antigen