Effect of antibiotic treatment on serum PSA and percent free PSA levels in patients with biochemical criteria for prostate biopsy and previous lower urinary tract infections

• Published in: The International journal of biological markers 2002-04, Vol.17 (2), p.84-89
• Main Authors: LORENTE, J. A, ARANGO, O, BIELSA, O, CORTADELLAS, R, GELABERT-MAS, A
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Biological and medical sciences; Biopsy; Host-tumor relations. Immunology. Biological markers; Humans; Male; Medical sciences; Nephrology. Urinary tract diseases; Prospective Studies; Prostate - pathology; Prostate-Specific Antigen - blood; Prostatic Hyperplasia - blood; Prostatic Neoplasms - blood; Prostatitis - blood; Tumors; Tumors of the urinary system; Urinary Tract Infections - blood; Urinary Tract Infections - drug therapy; Urinary tract. Prostate gland
• ISSN: 0393-6155; 1724-6008
• DOI: 10.1177/172460080201700202

Controversy exists as to the influence of inflammatory foci on total and free prostate-specific antigen (PSA) concentrations. The objective was to analyze the biological variations of PSA and percent free PSA (%f-PSA) in patients with biochemical criteria for prostate biopsy (PSA higher than 4 ng/mL and normal rectal examination) and compare them with the variation induced by antibiotic treatment in a cohort of patients with a history of lower urinary tract infections and no clinical evidence of prostatitis. Ninety patients with a history of lower urinary tract infections, non-suspicious digital rectal examination and PSA between 4 and 20 ng/mL were analyzed. PSA concentration and %f-PSA were determined. Forty-five patients were treated with three weeks of ofloxacin, following which marker determination was repeated. All patients underwent ultrasound-controlled transrectal six-core prostate biopsy. Sixty-seven patients presented benign prostatic hyperplasia (BPH) (30 with prostatitic foci) and 23 cancer. Significant variations in PSA (6.97 ng/mL vs. 5.82 ng/mL, p=0.001) and %f-PSA (14.84% vs. 17.53%, p=0.01) were found only in the treated patients. These differences were significant for patients with BPH-associated prostatitic foci and not for patients with BPH or cancer. The tendency was for PSA to decrease (15 treated patients with PSA