Treatment with levofloxacin does not resolve asymptomatic leucocytospermia--a randomized controlled study

The manual of the World Health Organization defines leucocytospermia as the presence of >1 x 10(6) white blood cells per ml semen. Most authors consider leucocytospermia to be a consequence of inflammation due to bacterial infection. However, the efficacy of antibiotic therapy was not unequivocally demonstrated until now. We started a prospective, randomized, controlled study in 36 patients, who consulted our department for infertility with leucocytospermia. None of the patients reported any symptoms of genital infection. The patients were assigned randomly to two groups: group 1 received 250 mg levofloxacin once a day over 10 days, patients of group 2 received no therapy. Semen analysis was repeated 2 weeks later. After administration of levofloxacin, a mean decrease of leucocyte count of 45.8 +/- 72.2% compared with a decrease of only 3 +/- 109.2% in the untreated group was observed. However, this difference is not statistically significant. There were no significant differences between the two groups with respect to leucocyte count, sperm count and sperm cell after treatment. We conclude from our study that antibiotic therapy does not provide benefit for treatment of asymptomatic leucocytospermia.