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Antibiotics may not decrease prostate-specific antigen levels or prevent unnecessary prostate biopsy in patients with

Lu Yang1, Yuchun Zhu1, Zhuang Tang1

  • 1Department of Urology, West China Hospital, Sichuan University, Chengdu, China.

Urologic Oncology
|March 11, 2015
PubMed
Abstract

Insights

Empiric antibiotics did not significantly lower prostate-specific antigen (PSA) levels or reduce the need for unnecessary prostate biopsies (PBs) in patients with moderately elevated PSA. Further research is needed to explore alternative strategies for managing elevated PSA levels.

Area of Science:

  • Urology
  • Pharmacology

Background:

  • Elevated prostate-specific antigen (PSA) levels often prompt prostate biopsies (PBs) to rule out cancer.
  • Empiric antibiotic treatment is sometimes used with the aim of reducing PSA levels and potentially avoiding unnecessary PBs.

Purpose of the Study:

  • To systematically evaluate the efficacy of empiric antibiotics in decreasing PSA levels.
  • To determine if empiric antibiotic use can help avoid unnecessary prostate biopsies.

Main Methods:

  • A systematic review and meta-analysis of 6 randomized controlled trials (RCTs) involving 656 patients.
  • Included studies compared empiric antibiotics with placebo or no treatment in patients with moderately increased PSA levels.
  • Statistical analysis was performed using Cochrane Collaboration Review Manager software.

Main Results:

  • No significant differences were observed between antibiotic and control groups in post-treatment PSA levels, decreased PSA levels, PSA density, or free/total PSA percentage.
  • The number of patients with responsive PSA and positive prostate cancer rates also showed no significant differences.
  • A significant net decrease in PSA was observed in the antibiotic group compared to the control group (MD = 1.44, P = 0.0001).

Conclusions:

  • Empiric antibiotic administration does not appear to significantly lower PSA levels.
  • The use of empiric antibiotics is unlikely to be effective in avoiding unnecessary prostate biopsies.
Keywords:
AntibioticProstate biopsyProstate cancerProstate-specific antigenRandomized controlled trial

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