Impacts of Antibiotic and Anti-Inflammatory Therapy on Serum Prostate Specific Antigen in Asymptomatic Men: Our Experience

Rosso, Alessandro Del; Saldutto, Pietro; Pierro, Ezio Domenico Di; Masciovecchio, Stefano; Galatioto, Giuseppe Paradiso; Vicentini, Carlo

doi:10.5301/ru.2012.9364

Cited by 8 publications

(7 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After use of antibiotic therapy, the PSA level was normalised by a wide variety of percentages, ranging from 16% to 59% [6-8,10,20,25,29,30]. Furthermore, the range of the PSA level decrease was 17-80% [4,13,15,18,20,23,29,32], or a > 20% decrease from baseline [24].…”

Section: Discussionmentioning

confidence: 99%

“…Six studies used ofloxacin [4,8,10,13,15,16], six studies used 500 mg ciprofloxacin [5,9,17,19,21,23], and five used levofloxacin [6,9,12,28]. Six studies combined the antibiotic therapy with NSAIDs [4,5,18,20,23,25]. Huang et al [21] added the plant extracts, Ningbitai and Yunnan Baiyao capsule, to the antibiotic therapy.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Morote et al [26] assessed benign tissue without inflammation in association with chronic prostatitis or acute prostatitis, whilst other studies focussed on patients presenting with LUTs only with normal urine analysis [6,13,19,23,24,27,31,32].…”

Section: The Studied Level Of Psamentioning

confidence: 99%

“…The PSA level was normalised by a wide variety of percentages and varied across the studies from 16% to 59% [7,8,20,25,29,30]. The PSA level decrease also varied widely and ranged from 17% to 80% [4,13,15,18,20,23,24,29,32].…”

Section: The Degree Of Psa Declinementioning

confidence: 99%

See 3 more Smart Citations

Antibiotic therapy in patients with high prostate-specific antigen: Is it worth considering? A systematic review

Taha

Aboumarzouk

Koraiem

et al. 2019

Arab Journal of Urology

View full text Add to dashboard Cite

Objective: To address the question of whether antibiotic therapy can obviate the need for prostate biopsy (PBx) in patients presenting with high prostate-specific antigen (PSA) levels.Methods: With the increase in unnecessary PBx in men with high PSA levels, a systematic review was performed according to the Cochrane Reviews guidelines and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Results: The literature search yielded 42 studies, of which 11 were excluded due to irrelevance of data. Most of the studies were retrospective, nine studies were randomised controlled trials, and there were seven prospective non-randomised trials. The age range of the patients was 51-95 years. Antibiotics, predominantly ofloxacin or ciprofloxacin, combined with a nonsteroidal anti-inflammatory drug (NSAID) or not, were prescribed for 2-8 weeks. All studies focussed on PSA levels ranging from ≤ 4 to ≥ 10 ng/mL. Furthermore, antibiotic therapy normalised PSA levels by a wide variety of percentages (16-59%), and the PSA level decrease also varied widely and ranged from 17% to 80%. For patients who had unchanged or decreased PSA, carcinoma was found in 40-52% and 7.7-20.3%, respectively. No cancer was detected if the PSA level decreased to < 4 ng/mL. Conclusion: Antibiotic therapy is clinically beneficial in patients with high PSA levels. PSA reduction or normalisation after medical therapy, either antibiotic and/or NSAID, for ≥ 2 weeks can avoid unnecessary PBx. Antibiotic therapy is more beneficial when the PSA level is < 20 ng/mL. Abbreviations: EPS: expressed prostatic secretion; PBx: prostate biopsy; (%f)(f/t)(t)PSA, (percentage free) (free/total) (total) serum PSA; PSAD: PSA density; RCT: randomised controlled trial; VB3: voided bladder urine 3 ARTICLE HISTORY

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: The Studied Level Of Psamentioning

confidence: 99%

Section: The Degree Of Psa Declinementioning

confidence: 99%

See 2 more Smart Citations

Antibiotic therapy in patients with high prostate-specific antigen: Is it worth considering? A systematic review

Taha

Aboumarzouk

Koraiem

et al. 2019

Arab Journal of Urology

View full text Add to dashboard Cite

show abstract

“…This approach, however, requires careful follow-up, especially for patients whose PSA levels fail to decrease to within the normal range ( 26 , 27 ). Kaygisiz ( 1 ) and Del Rosso ( 19 ) suggested that AT should be administered for 3 weeks, regardless of the presence of inflammation when PSA levels are in the grey zone, before making a decision regarding whether or not to carry out a biopsy.…”

Section: Discussionmentioning

confidence: 99%

Does PSA reduction after antibiotic therapy permits postpone prostate biopsy in asymptomatic men with PSA levels between 4 and 10ng/mL?

et al. 2015

View full text Add to dashboard Cite

Purpose We investigated the effect of antibiotics on PSA in asymptomatic patients with mild PSA elevation.Materials and Methods We prospectively evaluated, in a non-randomized design, 106 asymptomatic patients with PSA of 4-10ng/mL, with a negative digital rectal examination and with no urinary tract infection evidence for 2 years. Patients were divided into two groups: those treated with antibiotics for 3 weeks (G1) and those who were not treated (G2). PSA was taken six weeks after and prostate biopsy was performed in all patients.Results PCa was diagnosed in 25 of 106 patients (23.6%): 16 (25.0%) in G1 and 9 (21.4%) in G2 (p>0.05). PSA normalization was experienced in 24.5%. In G1, PSA returned to <4ng/mL in 15 (23.4%) patients compared to 11 (26%) patients in G2. In the patients with a positive biopsy, no significant variation was noted in PSA, fPSA, %fPSA and DPSA after antibiotic treatment. A significantly lower cancer detection rate was noted with decreased PSA, fPSA, and DPSA after antibiotic use. A PSA reduction rate of ≥10% occurred in 58.5%, and this was similar in both G1 and G2 groups. The sensibility, specificity and accuracy of PSA reduction of ≥10% were 31%, 23% and 25%, respectively.Conclusion Empirical antibiotic therapy in asymptomatic male patients is not related to PSA reduction. The greater than 10% PSA reduction after antibiotic in this population cannot postpone prostate biopsy.

show abstract

Elevated PSA as Differential Diagnostic Error-Source in Prostate Cancer with Consequences in Medical Law

Bichler

Naber

2016

Prostatitis and Its Management

View full text Add to dashboard Cite

Impacts of Antibiotic and Anti-Inflammatory Therapy on Serum Prostate Specific Antigen in Asymptomatic Men: Our Experience

Abstract: A combination of antibiotic and anti-inflammatory therapy seems to be a useful way to avoid unnecessary biopsies in patients with PSA range from 4 to 10 ng/ml.

Cited by 8 publications

References 16 publications

Antibiotic therapy in patients with high prostate-specific antigen: Is it worth considering? A systematic review

Antibiotic therapy in patients with high prostate-specific antigen: Is it worth considering? A systematic review

Does PSA reduction after antibiotic therapy permits postpone prostate biopsy in asymptomatic men with PSA levels between 4 and 10ng/mL?

Elevated PSA as Differential Diagnostic Error-Source in Prostate Cancer with Consequences in Medical Law

Contact Info

Product

Resources

About