Can the Effect of Antibiotherapy and Anti-Inflammatory Therapy on Serum PSA Levels Discriminate between Benign and Malign Prostatic Pathologies?

Erol, Haluk; Beder, Nahit; Caliskan, Tamer; Dündar, Mehmet; Ünsal, Alparslan; Çulhacı, Nil

doi:10.1159/000089730

Cited by 29 publications

(26 citation statements)

References 44 publications

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“…Ciprofloxacin is commonly prescribed with analgesics for the management of infection, pain and inflammation. Co-medication with ciprofloxacin and diclofenac occurs in many clinical situations [12][13][14] . Several reports have shown that co-administration of ciprofloxacin significantly decreased exposure of mycophenolic acid [15,16] , partly by inhibiting β-glucuronidase [17] .…”

Section: Introductionmentioning

confidence: 99%

Ciprofloxacin blocked enterohepatic circulation of diclofenac and alleviated NSAID-induced enteropathy in rats partly by inhibiting intestinal β-glucuronidase activity

et al. 2016

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Aim: Diclofenac is a non-steroidal anti-inflammatory drug (NSAID), which may cause serious intestinal adverse reactions (enteropathy). In this study we investigated whether co-administration of ciprofloxacin affected the pharmacokinetics of diclofenac and diclofenacinduced enteropathy in rats. Methods: The pharmacokinetics of diclofenac was assessed in rats after receiving diclofenac (10 mg/kg, ig, or 5 mg/kg, iv), with or without ciprofloxacin (20 mg/kg, ig) co-administered. After receiving 6 oral doses or 15 intravenous doses of diclofenac, the rats were sacrificed, and small intestine was removed to examine diclofenac-induced enteropathy. β-Glucuronidase activity in intestinal content, bovine liver and E coli was evaluated. Results: Following oral or intravenous administration, the pharmacokinetic profile of diclofenac displayed typical enterohepatic circulation, and co-administration of ciprofloxacin abolished the enterohepatic circulation, resulted in significant reduction in the plasma content of diclofenac. In control rats, β-glucuronidase activity in small intestinal content was region-dependent: proximal intestine

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Section: Introductionmentioning

confidence: 99%

Ciprofloxacin blocked enterohepatic circulation of diclofenac and alleviated NSAID-induced enteropathy in rats partly by inhibiting intestinal β-glucuronidase activity

et al. 2016

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“…The difference between pre-and post-treatment PSA levels appears significant only in benign conditions (BPH and prostatitis cases), while in histologically proven cancer cases the difference seems unremarkable [20] . NIH category IV CP appears to contribute to increased PSA levels even if no bacteria are found in expressed prostatic secretion [6] ; nevertheless, Magri et al [21] observed a 34.6% PSA reduction after antibiotics and Terrone et al [22] showed that the indication to biopsy subsided in 20-30%.…”

Section: Prostatitis and Pca Detection At Repeated Biopsymentioning

confidence: 88%

Does an Inflammatory Pattern at Primary Biopsy Suggest a Lower Risk for Prostate Cancer at Repeated Saturation Prostate Biopsy

Pepe¹,

Aragona²

2011

Urol Int

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Introduction: To evaluate if an inflammatory pattern at primary biopsy is associated with a lower risk for cancer in men submitted to repeated saturation prostate biopsy (SPBx). Methods: From January 2005 to January 2010, 320 patients, after a negative primary extended biopsy (median 18 cores), underwent SPBx by transperineal approach performing 27 cores (median). 210 (65.6%) patients had a normal parenchyma and 110 had an inflammatory pattern (34.4%) at primary biopsy (none of them complained of symptoms suggesting a diagnosis of acute prostatitis at the time of biopsy). Moreover, median prostate-specific antigen and abnormal digital rectal examination was equal to 7.3 ng/ml and 3.6% versus 8.2 ng/ml and 3.8%, respectively. Results: Prostate cancer (PCa) was found in 66 (20.5%) of 320 patients. Of these, 42 (63.6%) and 24 (36.4%; p = 0.007) had a histological diagnosis of chronic prostatitis and normal parenchyma at primary biopsy, respectively. Conclusions: An inflammatory pattern at primary biopsy is not associated with a decrease in PCa incidence at repeated SPBx; therefore, only an accurate clinical evaluation including more parameters (i.e. urinary PCA3) could hopefully select men who need to undergo rebiopsy in the presence of persistent suspicion of cancer.

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“…An elevated PSA level is reported to be related to prostatitis [4,6,7,12], and prostate inflammation is known to be a main reason for compromise of the specificity of PSA [13]. Many studies have shown that treatment of chronic prostatitis can decrease the PSA level, which suggests that the use of antimicrobial or nonsteroidal anti-inflammatory agents may reduce the number of men who require prostate biopsy [6,7].…”

Section: Discussionmentioning

confidence: 99%

Prostate Cancer Can Be Detected Even in Patients with Decreased PSA Less than 2.5 ng/ml after Treatment of Chronic Prostatitis

Kim

Ryu

et al. 2011

Korean J Urol

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PurposeWe evaluated men with documented chronic prostatitis and elevated serum prostate-specific antigen (PSA) to determine whether treatment with antibiotics and anti-inflammatory drugs can lower serum PSA and the cancer detection rate in patients with post-treatment PSA <4 ng/ml.Materials and MethodsEighty-six men who presented with serum PSA greater than 4 ng/ml and who were subsequently diagnosed with chronic prostatitis with greater than 10 white blood cells per high power field in expressed prostatic excretions were included in this prospective study. Patients meeting these criteria underwent treatment with a 4-week course of antibiotics and nonsteroidal anti-inflammatory agents. Follow-up PSA and transrectal ultrasonography-guided prostate biopsy were performed within 2 months of treatment for all patients.ResultsMean patient age was 56.2 years (range, 37-72 years). Mean PSA (ng/ml) decreased by 33.8%, from 8.12 (range, 4.02-24.8) to 5.37 (range, 1.35-12.94), after treatment (p=0.001). Pathological studies revealed prostate cancer in 18 cases (20.9%), chronic inflammation in 64 (74.4%), and benign prostatic hypertrophy in 4 (4.7%). The prostate cancer detection rate according to the follow-up PSA level, below 2.5, from 2.5 to 4.0, and above 4.0, was 13.3% (2/15), 13.6% (3/22), and 26.5% (13/49), respectively.ConclusionsWhen chronic prostatitis with elevated PSA is identified, antibiotic and anti-inflammatory treatment can lower these PSA levels. However, the possibility of prostate cancer remains in patients whose PSA level decreases to less than 4 ng/ml, even in those with a PSA level less than 2.5 ng/ml.

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Can the Effect of Antibiotherapy and Anti-Inflammatory Therapy on Serum PSA Levels Discriminate between Benign and Malign Prostatic Pathologies?

Cited by 29 publications

References 44 publications

Ciprofloxacin blocked enterohepatic circulation of diclofenac and alleviated NSAID-induced enteropathy in rats partly by inhibiting intestinal β-glucuronidase activity

Ciprofloxacin blocked enterohepatic circulation of diclofenac and alleviated NSAID-induced enteropathy in rats partly by inhibiting intestinal β-glucuronidase activity

Does an Inflammatory Pattern at Primary Biopsy Suggest a Lower Risk for Prostate Cancer at Repeated Saturation Prostate Biopsy

Prostate Cancer Can Be Detected Even in Patients with Decreased PSA Less than 2.5 ng/ml after Treatment of Chronic Prostatitis

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