title: Antimicrobial therapy for asymptomatic patients with elevated prostate-specific antigen: can the change in prostate-specific antigen reliably guide prostate biopsy decisions?
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Urology, Cairo University, Cairo, Egypt.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Torky
authors.forename: Ashraf
authors.initials: A
authors.lastname: Mosharafa
authors.forename: Ashraf
authors.initials: A
authors.lastname: Emran
authors.forename: Ayman
authors.initials: A
authors.lastname: Kamal
authors.forename: Mohammed
authors.initials: M
authors.lastname: Abdelhamid
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D058070:Asymptomatic Diseases; D001706:Biopsy; D003951:Diagnostic Errors / Q000517:prevention & control; D004334:Drug Administration Schedule; D004534:Egypt; D006801:Humans; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage*; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D011472:Prostatitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000276:immunology; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D015242:Ofloxacin; D017430:Prostate-Specific Antigen