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

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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