Antibiotics to “Treat” Patients with Mildly Elevated Prostate-Specific Antigen Levels?

Some clinicians prescribe antibiotics for patients with mildly elevated prostate-specific antigen (PSA) levels. The rationale is that asymptomatic prostatitis raises PSA levels and that a drop in PSA after antibiotic therapy provides reassurance that cancer is unlikely to develop. Urologists in Brazil conducted a randomized trial to examine this premise.

The researchers enrolled 98 asymptomatic men (age range, 50–75) with PSA levels between 2.5 and 10.0 ng/mL and normal digital rectal examinations who were considered to have asymptomatic prostatitis (they had defined increases in white cell counts in post–prostatic-massage urine or urethral secretions). Each man received a 4-week course of either ciprofloxacin or placebo; PSA levels were the…