Don’t treat an elevated prostate-specific antigen (PSA) with antibiotics for patients not experiencing other symptoms.
|Rationale and Comments:||It had previously been suggested that a course of antibiotics might lead to a decrease in an initially raised PSA and reduce the need for prostate biopsy; however, there is a lack of clinical studies to show that antibiotics actually decrease PSA levels. It should also be noted that a decrease in PSA does not indicate an absence of prostate cancer. There is no information available on the implications of deferring a biopsy following a decrease in PSA.|
|References:||• Heldwein FL, et al. Antibiotics and observation have a similar impact on asymptomatic patients with a raised PSA. BJU Int. 2011;107(10):1576-81.
• Stopliglia RM, et al. Prostate specific antigen and prostate cancer diagnosis: antibiotic versus placebo prospective randomized clinical trial. J Urol.2010;183(3):940-4.