Predictive Parameters on the Effect of Ofloxacin Treatment on the Reduction of PSA in Patients With Elevated PSA Level
Authors: Kerem TEKE , Yavuz Onur DANACIOĞLU , Salih POLAT
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Aim: To evaluate the effect of ofloxacin treatment on reduction of prostate spesific antigen (PSA) values and aimed to define the predictive biomarkers for PSA-decreasing after treatment.
Materials and methods: All consecutive 99 outpatients patients with total PSA > 4 ng/ml and treated with ofloxacin for 15 days were retrospectively identified and evaluated for PSA response two weeks after the end of antibiotic therapy. The patient’s demographic, radiologic, and laboratory data were enrolled. After determination of median change of total prostate spesific antigen (tPSA), the patient cohort was categorized two groups as Group-1 (no reduction as more as in the median PSA value) and Group-2 (more reduction than the median PSA value). The differences of demographic, radiologic and laboratory data between the two groups were evaluated statistically. The ROC analysis was performed for statistically significant parameters.
Results: tPSA, free PSA (fPSA), and PSA density (PSAD) were significantly decreased after the treatment. The median reduction of tPSA was -27,9% (range -%96,7 – +%101,4). The pretreatment parameters of C-reactive protein (CRP), white blood cells (WBC), tPSA, creatinine, PSAD values were observed higher in group 2 than group-1 (p<0,05). The findings on radiological and demographic of the groups were statistically similar for other parameters except urethral catheterization (p=0,023). According to the ROC analysis, the cut-off values for tPSA, PSAD, CRP, creatinine and WBC for predicting the PSA-decreasing effect of oflaxosin were 9,66 ng/mL, 0,10, 2,53 mg/dL, 0,94 mg/dL, and 7,60 103, respectively (p<0,05).
Conclusion: Ampiric antibiotherapy is commonly applied in daily urologic practice due to the elevated of PSA levels. The predictive values of PSAD, CRP, creatinine and WBC for the PSA-decreasing effect following to use 2nd generation quinolone may be utilized the follow-up of the treatment.