Objectives: To evaluate the impact of antibiotic treatment in patients with higher-than-normal prostate-specific antigen (PSA) levels in terms of changes both in total PSA and free/total (f/t) PSA ratios. Materials and Methods: Serum PSA and f/t PSA changes after antibiotic treatment in 85 patients with normal digital rectal examination but elevated age-adjusted serum PSA levels were evaluated with relevance to biopsy results. Results: Serum PSA levels decreased after antibiotic treatment in 47 of 85 patients. The f/t PSA ratio decreased or remained unchanged in 21 and increased in 26 of these 47 cases. Cancer detection rate in the former group was 52.4% (11/21), while it was 7.7% (2/26) in the latter (p = 0.002). There were 38 patients with increased PSA levels after antibiotics. The f/t PSA ratios decreased or remained unchanged in 20 and increased in 18 of these 38 cases. Cancer detection rates were 55% (11/20) in the former and 16.7% (3/18) in the latter group (p = 0.003). Conclusions: The PSA and f/t PSA levels may change with long-term antibiotic treatment in patients with elevated PSA values. The f/t PSA ratio rather than total PSA appears to be more helpful in suggesting prostate cancer in these cases.

Keywords:
Antibiotic treatment, Chronic prostatitis, Prostate biopsy, Prostate cancer, Prostate-specific antigen
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© 2009 S. Karger AG, Basel
2009
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