Effect of empirical antibiotic treatment on prostate specific antigen in men with borderline raised serum prostate specific antigen

Abstract

OBJECTIVE: To assess the effect of four weeks Ciprofloxacin treatment on serum prostate specific antigen (PSA) in men with PSA 4-10 ng/ml.

MATERIALS AND METHODOLOGY: This Randomized Control Trail (RCT) was conducted in Urology Department, Institute of Kidney Diseases Hayatabad Medical Complex Peshawar over a period of six months from 15 February to 15 August, 2019. Men aged 50-80 years with serum PSA 4-10 ng/ml, normal DRE and no hypoechoic lesion in prostate on TRUS were included in the study. Patients were assigned to the two study groups by block randomization. Treatment Group received Tab Ciprofloxacin 500mg 1 tab per oral at interval of 12 hours for four weeks and Control Group was followed without any treatment for four weeks. Serum PSA level was re-checked after 4 weeks in both the groups.

RESULTS: A total of 60 male patients were included in the study. In the treatment group the mean baseline serum PSA levels was 5.4+0.47ng/ml, repeat serum PSA levels was 3.3+0.49 ng/ml and mean change in serum PSA was 1.95+0.60 ng/ml. In the control group the mean baseline serum PSA levels was 5.4+0.32ng/ml, repeat serum PSA levels was 4.7+0.38 ng/ml and mean change in serum PSA was 0.6+0.24 ng/ml The mean change in serum PSA in the treatment group was lower than the mean change in the control group (p < 0.05).

CONCLUSION: Our study concluded that empirical antibiotic treatment in men with PSA 4-10 ng/ml, normal DRE and normal prostate on TRUS significantly decreases the serum PSA levels and can be a useful tool to avoid unnecessary biopsies in patients with borderline raised PSA levels.

KEYWORDS: Anti-biotic therapy, BPH, Prostate Cancer, PSA