A course of fluoroquinolone antibiotics may be unwarranted in asymptomatic men with an elevated PSA level, according to researchers.

In a single-center prospective trial of 150 men with an initial elevated PSA level, Alyssa Greiman, MD and colleagues at the Medical University of South Carolina in Charleston randomly assigned patients to receive 6 weeks of ciprofloxacin or observation. Of 136 men who completed the trial, 63 were in the treatment arm and 73 were in the observation arm. PSA level declined by an average of 0.68 ng/mL in the treatment arm and 0.01 ng/mL in the observation group, a difference that was borderline significant, investigators reported in Urology (2016;90:32-38). Among the men who underwent biopsy, prostate cancer was diagnosed in the first biopsy In 24 (63%) patients in the treatment group compared with 27 (52%) of the observation group during follow-up, a non-significant difference.

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