Özet:

Objective: The purpose of this observational study is to investigate the effect of urologists daily practice antibiotic usage on prostate biopsy rates and clinically insignificant cancer diagnosis rates in patients with gray-zone prostate specific antigen (PSA). Materials and Methods: Two hundred thirty two patients who have PSA values between 2.5 and 10 ng/mL were studied prospectively. Patients convinced that he can benefit from the antibiotherapy were treated with levofloxacin 500 mg orally for 14 days by different urologist. At the end of treatment, serum PSA levels were measured again. PSA values of untreated patients were repeated after 14 days. Patients were reevaluated by same urologists with second PSA values for biopsy indication. Groups compared for biopsy rate, biopsy-to-prostate cancer detection rate, prostate cancer rate of population (Table 1, Prostate Cancer Rate 2), and Gleason 6 Prostate Cancer rate. Results: One hundred thirty six patients were treated with levofloxacin 500 mg for 2 weeks. Ninety six patients was untreated. PSA did not change or increased in 47 (35%) of patients which treated with antibiotics. Eight-nine (65%) patients had a decrease in PSA. Fewer biopsy indications were given in the group treated with antibiotics (p<0.001). When the all (biopsied and non-biopsied) patient groups were taken into consideration, fewer patients were diagnosed with prostate cancer in the treatment group (p=0.024). In the treatment group Gleason 6 cancer was 29%. Same rate was 45% in control group. Conclusion: Although antibiotherapy leads urologists to make less biopsy, the rate of cancer diagnosed by biopsy does not increase.

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