Schaeffer Anthony J, Wu Shu-Chen, Tennenberg Alan M, Kahn James B
Northwestern University Medical School, Chicago, Illinois, USA.
J Urol. 2005 Jul;174(1):161-4. doi: 10.1097/01.ju.0000162017.24965.2b.
We compared baseline and post-therapy prostate specific antigen (PSA) in patients with chronic bacterial prostatitis who were treated with levofloxacin or ciprofloxacin.
Subset analysis was done using a randomized, multicenter, double-blind, active control trial of 500 mg levofloxacin daily for 28 days vs 500 mg ciprofloxacin twice daily in 28 days in men with chronic bacterial prostatitis.
Of the 377 men in the intent to treat population, including 197 treated with levofloxacin and 180 treated with ciprofloxacin, 35 on levofloxacin and 37 on ciprofloxacin with baseline PSA greater than 4 ng/ml were included in this analysis. Excluded from analysis were 2 levofloxacin treated patients with extremely high PSA at baseline (62 and 103 ng/ml, respectively). Mean baseline PSA +/- SD in the patients analyzed was 8.33 +/- 4.46 ng/ml, which decreased to 5.36 +/- 3.82 ng/ml after therapy. There was no significant difference in the mean change in PSA between the levofloxacin and ciprofloxacin groups. Approximately 42% of patients with increased baseline PSA had a post-therapy PSA of 4 ng/ml or less. Of patients who were microbiologically evaluable and had normalized PSA after therapy levofloxacin eradicated the pathogen in 90.9% (10 of 11). However, of patients in whom post-therapy PSA remained increased the microbiological eradication rate was 69.2% (9 of 13). Similarly 93.3% of the ciprofloxacin group (14 of 15 patients) with normalized post-therapy PSA experienced microbiological eradication compared with 61.5% (8 of 13) with continued increased PSA after therapy.
Approximately 20% of patients diagnosed with chronic bacterial prostatitis had increased PSA. A significant decrease in PSA was observed in these patients after treatment with levofloxacin or ciprofloxacin. An association was observed between bacterial persistence and the likelihood that PSA would return to normal.
我们比较了接受左氧氟沙星或环丙沙星治疗的慢性细菌性前列腺炎患者的基线和治疗后前列腺特异性抗原（PSA）水平。
采用一项随机、多中心、双盲、活性对照试验进行亚组分析，该试验中，慢性细菌性前列腺炎男性患者分别接受每日500mg左氧氟沙星治疗28天与每日两次500mg环丙沙星治疗28天。
在377名意向性治疗人群中，包括197名接受左氧氟沙星治疗和180名接受环丙沙星治疗的患者，本分析纳入了35名基线PSA大于4ng/ml的左氧氟沙星治疗患者和37名基线PSA大于4ng/ml的环丙沙星治疗患者。2名基线PSA极高（分别为62和103ng/ml）的左氧氟沙星治疗患者被排除在分析之外。分析的患者中，平均基线PSA+/-标准差为8.33+/-4.46ng/ml，治疗后降至5.36+/-3.82ng/ml。左氧氟沙星组和环丙沙星组PSA的平均变化无显著差异。基线PSA升高的患者中，约42%治疗后的PSA为4ng/ml或更低。在微生物学可评估且治疗后PSA恢复正常的患者中，左氧氟沙星根除病原体的比例为90.9%（11例中的10例）。然而，治疗后PSA仍升高的患者中，微生物学根除率为69.2%（13例中的9例）。同样，治疗后PSA恢复正常的环丙沙星组患者中，93.3%（15例中的14例）实现了微生物学根除，而治疗后PSA持续升高的患者中这一比例为61.5%（13例中的8例）。
约20%诊断为慢性细菌性前列腺炎的患者PSA升高。这些患者接受左氧氟沙星或环丙沙星治疗后，PSA显著下降。观察到细菌持续存在与PSA恢复正常的可能性之间存在关联。
