Role of Antibiotic in preventing prostate biopsy in patients with psa level 4-10 ng/ml with normal DRE

Dr Ravi Ranjan; Dr Rakesh Ranjan; Dr Nabal Kumar Mishra

Volume : VIII, Issue : XI, November - 2019

Role of Antibiotic in preventing prostate biopsy in patients with psa level 4-10 ng/ml with normal DRE

Dr Ravi Ranjan, Dr Rakesh Ranjan, Dr Nabal Kumar Mishra

Abstract :

Objectives– To evaluate the antibiotic treatment in preventing prostate biopsy in patients with PSA level 4–10 ng/ml with normal DRE. Methods– The study was a prospective randomized open–label trial including 108 patients divided into study group (58patients) and control group (50 patients) done in the department of urology and renal transplant vmmc and safdarjung hospital new delhi, from october 2016 to october 2017.Study Group patients were given ofloxacin 400 mg twice daily for 4 weeks. PSA repeated. Patients again divided into 2 groups– PSA < 4ng/ml and PSA >4 ng/ml. Standard 12–core biopsy was done in all patients. Percentage of patients positive for malignancy were observed and analyzed in both groups. Control Group patients received multivitamin capsules for 4 weeks. Results– 26 of 58 patients (44.8%) in study group and 8 of 50 patients (16%) in control group had decrease in PSA level below 4ng/ml. Among the study group patients, cancer was found in only 02 of 26 patients (7.6%) whose repeat PSA was below 4ng/ml whereas cancer was diagnosed in 14 of 32 patients (43.7%) whose repeat PSA was above 4ng/ml. Conclusion– 4 weeks of ofloxacin treatment significantly decreases PSA in patients with levels between 4–10 ng/ml. Biopsy can be avoided in patients with repeat PSA<4ng/ml after antibiotic treatment. Larger randomized blinded control trials are required for arriving at a definitive conclusion.