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PSA decrease after levofloxacin therapy in patients with histological prostatitis.

Stefano Guercio1, Carlo Terrone, Roberto Tarabuzzi

  • 1University of Turin, San Luigi Gonzaga Hospital, Urological Clinic, Department of Clinical and Biological Sciences, Italy.

Archivio Italiano Di Urologia, Andrologia : Organo Ufficiale [Di] Societa Italiana Di Ecografia Urologica E Nefrologica
|February 8, 2005
PubMed
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Levofloxacin (LVX) oral therapy significantly reduced prostate-specific antigen (PSA) levels in over half of patients with prostatitis. This antibiotic approach may improve PSA test specificity and reduce unnecessary prostate biopsies.

Area of Science:

  • Urology
  • Pharmacology

Background:

  • Elevated total prostate-specific antigen (PSA) with normal digital rectal examination (DRE) and urinalysis can be challenging to interpret.
  • Histological prostatitis is a common condition that may contribute to elevated PSA levels.

Purpose of the Study:

  • To assess the impact of oral levofloxacin (LVX) on total serum PSA in patients diagnosed with histological prostatitis.
  • To determine if LVX therapy can help differentiate between prostatitis and prostate cancer in patients with elevated PSA.

Main Methods:

  • Retrospective evaluation of 26 outpatients with histological chronic prostatitis and PSA > 4 ng/ml.
  • Patients received oral levofloxacin (LVX) 500 mg once daily for 20 days.
  • Total serum PSA reduction > 5% was considered a positive response to antibiotic therapy.

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Main Results:

  • Median PSA decreased from 7.1 ng/ml to 5.8 ng/ml (not statistically significant overall).
  • However, 57.6% of patients (15/26) showed a statistically significant PSA reduction (p=0.002), with a median decrease of 16.6%.
  • Prostate cancer was detected in 1/8 patients with significant PSA reduction and 4/11 patients without significant reduction, indicating potential for improved diagnostic specificity.

Conclusions:

  • Oral levofloxacin significantly reduced PSA values in over half of patients with asymptomatic prostatitis and elevated PSA.
  • This ambulatory treatment strategy may enhance the specificity of PSA testing.
  • The findings suggest a potential to decrease the number of unnecessary prostate biopsies.