INTRODUCTION: To determine the duration of antibiotherapy to decrease TPSA levels to normal ranges in patients without prostatitis symptoms but with total PSA levels 4.01--9.9 ng/dl.
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MATERIAL AND METHOD: A total of 129 male patients were enrolled and divided into either study group (n:102) or control group (n:27). Study group received 21 days course of Ofloxacin 400 mg/day treatment and control group did not receive any treatment. TPSA and free PSA levels were measured at 7th, 14th, 21st days and 3rd, 6th, 12th months of the study. TPSA levels and the number of patients whose TPSA levels decreased ≤ 4.0 ng/dl levels was recorded and analyzed for statistical significance.
RESULTS: At 7th, 14th, and 21st days mean TPSA values were all lower than baseline values and the differences was statistically significant (p< 0.05). Of 102 patients 31, 38 and 36 patients had decreased TPSA levels at 7th, 14th, and 21st days, respectively. But when we compared 7th day mean TPSA levels with 14th and 21st days we found no statistical differences (p>0.05). 66 patients had persistent high TPSA levels and 64 of them underwent prostate biopsy. Prostate cancer was detected in 8 of them (12.5%).
CONCLUSION: Seven days course of antibiotherapy (not longer) will be enough to normalize PSA levels in gray zone patients. If repetitions of PSA increases are seen during follow--up, antibiotherapy will be again useful in the patients who previously benefited and will be unnecessary in those who did not have normalized TPSA levels.
Topac H, Goktas S, Basal S, Zor M, Yildirim I, Dayanc M. Are you the author?
Konya Military Hospital, Department of Urology, Konya, Turkey.
Reference: Minerva Urol Nefrol. 2014 Jul 11. Epub ahead of print.