{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T23:24:44Z","timestamp":1776122684572,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,7,26]],"date-time":"2013-07-26T00:00:00Z","timestamp":1374796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2013,11]]},"abstract":"\n Objective<\/jats:title>\n \n \n \n \n To determine the impact of empiric antibiotics on men with an elevated prostate\u2010specific antigen (\n PSA<\/jats:styled-content>\n ) level.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Subjects\/Patients and Methods<\/jats:title>\n \n \n \n \n Men of any age with a\n PSA<\/jats:styled-content>\n level of >2.5\u2009ng\/mL and normal digital rectal examination undergoing their first prostate biopsy were recruited from five medical centres.\n <\/jats:p>\n <\/jats:list-item>\n \n \n Patients with previous biopsy, prostate cancer, urinary tract infection (\n UTI<\/jats:styled-content>\n ) or prostatitis within the prior year, antibiotic use within 1 month, 5\u03b1\u2010reductase inhibitor use, allergy to fluoroquinolones or clinical suspicion of\n UTI<\/jats:styled-content>\n were excluded.\n <\/jats:p>\n <\/jats:list-item>\n \n \n Men were randomised to 2 weeks of ciprofloxacin or no antibiotic. A\n PSA<\/jats:styled-content>\n measurement was obtained 21\u201345 days after randomisation immediately before prostate biopsy.\n <\/jats:p>\n <\/jats:list-item>\n \n \n The primary endpoint was the change in\n PSA<\/jats:styled-content>\n level between baseline and immediately before biopsy.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n \n \n Complete data were available for 77 men with a mean (interquartile range) age of 60.6 (53\u201366) years.<\/jats:p>\n <\/jats:list-item>\n \n \n In the control group of men not receiving antibiotic (39 men), the mean baseline and pre\u2010biopsy\n PSA<\/jats:styled-content>\n levels were 6.5 and 6.9\u2009ng\/mL, respectively (\n P<\/jats:italic>\n = 0.8).\n <\/jats:p>\n <\/jats:list-item>\n \n \n In men receiving ciprofloxacin (38 men), the mean baseline\n PSA<\/jats:styled-content>\n level was 7.6\u2009ng\/mL and after 2 weeks of ciprofloxacin was 8.5\u2009ng\/mL (\n P<\/jats:italic>\n = 0.7).\n <\/jats:p>\n <\/jats:list-item>\n \n \n Compared with controls not receiving antibiotic, use of ciprofloxacin was not associated with a statistically significant change in\n PSA<\/jats:styled-content>\n level (\n P<\/jats:italic>\n = 0.33).\n <\/jats:p>\n <\/jats:list-item>\n \n \n Prostate cancer was detected in 36 (47%) men, 23 (59%) in the control group and 13 (34%) in the antibiotic group (\n P<\/jats:italic>\n = 0.04). Detection rates were not significantly associated with the change in\n PSA<\/jats:styled-content>\n level between baseline and biopsy. The primary limitation of the study is early stoppage due to an interim futility analysis and poor accrual.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n \n \n \n Despite not meeting the target accrual goal, empiric use of antibiotics for asymptomatic men with an elevated\n PSA<\/jats:styled-content>\n level does not appear to be of clinical benefit.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.12241","type":"journal-article","created":{"date-parts":[[2013,7,26]],"date-time":"2013-07-26T22:38:53Z","timestamp":1374878333000},"page":"925-929","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Empiric antibiotics for an elevated prostate\u2010specific antigen (\n PSA<\/scp>\n ) level: a randomised, prospective, controlled multi\u2010institutional trial"],"prefix":"10.1111","volume":"112","author":[{"given":"Scott E.","family":"Eggener","sequence":"first","affiliation":[{"name":"Section of Urology University of Chicago Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael C.","family":"Large","sequence":"additional","affiliation":[{"name":"Section of Urology University of Chicago Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn S.","family":"Gerber","sequence":"additional","affiliation":[{"name":"Section of Urology University of Chicago Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Pettus","sequence":"additional","affiliation":[{"name":"North Alabama Urology Huntsville AL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ofer","family":"Yossepowitch","sequence":"additional","affiliation":[{"name":"Department of Urology Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norm D.","family":"Smith","sequence":"additional","affiliation":[{"name":"Section of Urology University of Chicago Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shilajit","family":"Kundu","sequence":"additional","affiliation":[{"name":"Department of Urology Northwestern University Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rangesh","family":"Kunnavakkam","sequence":"additional","affiliation":[{"name":"Department of Health Studies University of Chicago Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Zorn","sequence":"additional","affiliation":[{"name":"Department of Urology University of Montreal Montreal QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay D.","family":"Raman","sequence":"additional","affiliation":[{"name":"Division of Urology Penn State Milton S. 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