The Effect of Ofloxacin in Men With Elevated Prostate Specific Antigen

Abstract Background: Antibiotic prescription is a common practice in men with elevated serum prostate specific antigen. The thought is that if patients were to have a drop in, or normalization of their PSA, we can be able to avoid unnecessary prostate biopsy. The aim of this study was to evaluate the effect of ofloxacin in men with elevated PSA.Methods: 224 men with elevated PSA from the base of 4 ng/ml were enrolled in this study. Exclusion criteria were age less than 50 or greater than 75, history of allergy to fluoroquinolones, cases with history of recent prostate manipulation, men on 5 alpha reductase inhibitors, and known cases of prostate cancer. After a duration of 10 days ofloxacin 200 mg twice a day orally, PSA level was rechecked.Results: Mean age was 61.18 year. Mean PSA level before administering antibiotic was 26.3 ng/ml (-21.9 +97.4). In 120 patients (53.57%) a significant drop in serum PSA was detected so prostate biopsy was not done and in the remainder 104 patients (46.43%), Prostate biopsy was done that showed 65 adenocarcinomas of prostate and 39 benign prostate hyperplasia. Conclusions: This study showed in a patient with active urinalysis (pyuria) and normal rectal examination, trans rectal ultrasonography and prostate biopsy should be post ponded and antibiotic be started. If significant drop in serum PSA was seen, antibiotic should be continued to avoid unnecessary biopsies, otherwise, no benefit in asymptomatic men with normal urinalysis, but elevated PSA.