Impacts of antibiotic and anti-inflammatory therapies on serum prostate-specific antigen levels in the presence of prostatic inflammation: a prospective randomized controlled trial.
BACKGROUND
The aim of this study was to determine if antibiotic or anti-inflammatory medications lower serum prostate-specific antigen (PSA) in the presence or absence of inflammation in the prostatic secretions of patients with PSA levels between 2.5 and 10 ng/ml and normal digital rectal examinations (DRE).


METHODS
Patients with PSA levels between 2.5 and 10 ng/ml and normal DRE were candidates for the study. One hundred and eight patients with positive expressed prostate secretion (EPS) were randomized into antibiotics, anti-inflammatory and control groups (groups 1, 2 and 3, respectively), and 108 patients with negative EPS were randomized into similar groups (groups 4, 5 and 6, respectively). Repeat PSA levels of all patients were obtained 6 weeks after randomization and 10 core prostate biopsies were performed.


RESULTS
Median PSA levels in group 1 before and after treatment were 5.2 (4.3-6.4) and 4.0 ng/ml (3.1-4.9), respectively (p < 0.001). The only significant decrease in PSA was observed in group 1. The percent change in PSA levels in group 1 was significantly greater than both in its control group (group 3; p < 0.001) and the EPS- antibiotics group (group 4; p < 0.001).


CONCLUSIONS
Antibiotherapy significantly reduces serum PSA only in EPS+ patients, which justifies limiting the use of prebiopsy antibiotics to EPS+ patients with a normal DRE and PSA level between 2.5 and 10 ng/ml, minimizing the major drawbacks of empirical antibiotics usage.
Ugurlu
Ozgur
O
Department of Urology, Ankara Numune Education and Research Hospital, Ankara, Turkey. ugurluozgur @ hotmail.com
Yaris
Mehmet
M
Oztekin
C Volkan
CV
Kosan
T Murat
TM
Adsan
Oztug
O
Cetinkaya
Mesut
M
D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D001706:Biopsy / Q000379:methods; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000378:metabolism / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000628:therapy; D011472:Prostatitis / Q000188:drug therapy* / Q000378:metabolism; D018401:Sample Size
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D017430:Prostate-Specific Antigen