PSA levels of 4.0 - 10 ng/ml and negative digital rectal examination: antibiotic therapy versus immediate prostate biopsy
Int. braz. j. urol
;
35(5): 551-558, Sept.-Oct. 2009. tab
Article
Dans Anglais
| LILACS
| ID: lil-532768
ABSTRACT
Purpose:
The management of mildly elevated (4.0-10.0 ng/ml) prostate specific antigen (PSA) is uncertain. Immediate prostate biopsy, antibiotic treatment, or short term monitoring PSA level for 1-3 months is still in controversy. Material andMethods:
We conducted a retrospective chart review of patients in a large community practice (2003 - 2007) who had PSA levels between 4.0-10 ng/mL without any further evidence of infection. Data was gathered regarding patient's age, whether standard antibiotic therapy (10-14 days of ofloxacin or ciprofloxacin) had been administered before the second PSA measurement, results of a second PSA test performed at 1- to 2-month intervals, whether a prostate biopsy was performed and its result.Results:
One-hundred and thirty-five men met the study inclusion criteria with 65 (48.1 percent) having received antibiotics (group 1); the PSA levels decreased in 39 (60 percent) of which, sixteen underwent a biopsy which demonstrated prostate cancer in 4 (25 percent). Twenty-six (40 percent) patients of group 1 exhibited no decrease in PSA levels; seventeen of them underwent a biopsy that demonstrated cancer in 2 (12 percent). The other 70 (51.9 percent) patients were not treated with antibiotics (group 2); the PSA levels decreased in 42 (60 percent) of which, thirteen underwent a biopsy which demonstrated prostate cancer in 4 (31 percent). In the other 28 (40 percent) patients of group 2 there was no demonstrated decrease in PSA, nineteen of these subjects underwent a biopsy that demonstrated cancer in 8 (42 percent).Conclusions:
There appears to be no advantage for administration of antibacterial therapy with initial PSA levels between 4-10 ng/mL without overt evidence of inflammation.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Hyperplasie de la prostate
/
Tumeurs de la prostate
/
Biopsie
/
Antigène spécifique de la prostate
/
Toucher rectal
/
Antibactériens
Type d'étude:
Etude diagnostique
/
Étude observationnelle
Limites du sujet:
Adulte très âgé
/
Humains
/
Mâle
langue:
Anglais
Texte intégral:
Int. braz. j. urol
Thème du journal:
Urologie
Année:
2009
Type:
Article
Pays d'affiliation:
Israël
Institution/Pays d'affiliation:
Tel Aviv Central Consulting Clinic/IL
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