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N28 Reduction of PSA values after levofloxacin therapy in patients with PSA greater than 4 ng/ml: Implications for prostate cancer detection

      Introduction and Objectives

      Asymtomatic prostatitis may induce prostate-specific antigen (PSA) increase. PSA reduction-after antibiotics might identify those patients in whom biopsy can be avoided. The aim of our study was to investigate the possibility of reducing the number of prostate biopsies in patients showing PSA decrease or normalization after antibiotic therapy.

      Material and Methods

      This retrospective study was carried out between 2005 and 2007 in a university hospital. The study population comprised 274 subjects who underwent prostate cancer screening in our institution. Levofloxacin (LVX, 500 mg once a day.) was given orally for 3 weeks. Basal total-PSA (t-PSA) and free-PSA (f-PSA) determinations were repeated in all patients at study entry and after 3 week treatment with LVX, were compared.

      Results

      235 patients (85.76%) showed PSA reduction after the therapy (Group I). In 39 of them (14.23%) PSA was increased (Group II) 39 of 235 patients had prostate cancer in Group I (16.5%). 8 of 39 patients had prostate cancer in Group II (20.5%). Mean PSA reduction was 18.4% in patients with benign pathology group (n:196) while it was 11.9% in patients with prostat cancer group (n:39)(p = 0.01). Initial PSA were found 9.36 ng/ml in patients with chronic prostatitis while it was 8.42 ng/ml in patients without chronic prostatitis (p = 0.04).

      Conclusions

      The treatment with LVX allowed to significantly decrease PSA values in 85.7% of the patients with asymptomatic prostatitis and PSA greater than 4.0 ng/ml. This approach could be useful in order to increase the specificity of PSA testing, reducing the number of unnecessary prostate biopsies.