Predictive Parameters on the Effect of Ofloxacin Treatment on the Reduction of PSA in Patients With Elevated PSA Level

Year 2019, Volume: 14 Issue: 3, 166 - 175, 01.10.2019

Kerem Teke , Yavuz Onur Danacıoğlu , Salih Polat

https://doi.org/10.33719/yud.512057

Abstract

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.

Keywords

Chronic prostatitis , PSA , ofloxacin

PSA Yüksekliği Olan Hastalarda Ofloksasin Tedavisinin PSA Düşürücü Etkisini Öngörücü Parametreler

Abstract

Giriş: Bu
çalışmada ofloksasin tedavisinin PSA düşüşü üzerine olan etkinliğinin ve PSA
düşüşünü öngören biyo-belirteçlerin belirlenmesi amaçlanmıştır. Çalışmamızda oflaksosin tedavisinin PSA (prostat
spesifik antijen) üzerindeki düşürücü etkisini
inceleyip, düşüşünü öngören parametreleri
saptamayı amaçladık.

Gereç ve Yöntemler:
PSA değeri 4 ng/dl ve üzeri olan ve 15
günlük oflaksosin tedavisi verilerek kontrole gelen 99 hastanın kayıtları
retrospektif olarak incelendi. Hastaların demografik, radyolojik ve laboratuvar
verileri kaydedildi. Tedavi öncesi ve sonrası PSA değerindeki ortanca
değişiklik kadar azalma gözlenmeyen veya artış olan hastalar Grup-1, ortanca
değişiklik veya bu miktardan daha fazla azalmaya sahip olan hastalar Grup-2
olarak kategorize edildi. Bu iki grup arasındaki tedavi öncesi demografik
veriler, radyolojik ve laboratuvar bulguları arasındaki farklar istatistiksel
olarak değerlendirildi. İstatistiksel anlamlı çıkan parametreler için ROC
analizi yapıldı.

Bulgular: Çalışmamızda ofloksasin tedavisi sonrasında total PSA
(tPSA), serbest PSA (sPSA), PSA dansitesi (PSAD) değerlerinde istatistiksel
olarak anlamlı düşüş izlendi. tPSA’daki ortanca değişim -%27,9 olup (-%96,7 –
+%101,4), %27,9 dan daha fazla düşüş gözlenmeyen Grup-1 (n=50)’e göre, %27.9 ve
daha fazla miktarda tPSA düşüşü olan Grup 2 (n=49)’de tedavi öncesi laboratuvar
parametrelerinden CRP, beyaz küre sayısı (BKS), tPSA ve kreatinin değerlerinin
istatistiksel anlamlı olarak daha fazla olduğu bulundu (p<0,05). Radyolojik
ve demografik verilerde ise üretral kateterizasyon (p=0,023) öyküsü dışında
diğer parametreler için bir fark gözlenmedi. Yapılan ROC analizine göre
oflaksosin’in PSA düşürücü etkisini öngörmede tPSA, PSAD, CRP, kreatinin, BKS
için cut-off değerleri ise sırasıyla 9,66
ng/mL 0,10, 2,53 mg/dL, 0,94 mg/dL ve 7,60 103/uL olarak bulundu (p<0,05).

Sonuç: Günlük ürolojik uygulamalarda PSA yüksekliği nedeniyle sıklıkla antibiyoterapi uygulanmaktadır.
2. Kuşak kinolon kullanımı ile sağlanan PSA düşürücü etkinin öngörülmesinde
belirlediğimiz tPSA, PSAD, CRP, kreatinin, BKS tedavi izleminde kullanılabilecek
parametreler olarak kabul edilebilir.

Keywords

Kronik prostatit , PSA , ofloksasin

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