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Antibiotics or No Antibiotics this is the question

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Posted 1/12/2018 4:28 PM (GMT -5)
My former URO gave me two weeks of Bactrim to take back in November to deal what he felt was/is prostatitis; my PSA went down from 3.8-2.7; all other initial tests negative.

My new URO that I saw just before Christmas said that it was NOT antibiotics that brought the PSA down. He said it came down on it's own and that Bactrim has nothing to do with it.

He also said that when my PSA is retested in May if it is no increase he wouldn't want to see me until I'm 55.

What is the consensus from the board about antibiotics vs no antibiotics to lower PSA or to treat prostatitis which lowers PSA? Seems to be a debate in the medical community and secondly if you were in my shoes and PSA stays at 2.7 or is a bit lower would you wait until 55 (I'm 47 now) to get PSA done or would you tell him that you're coming back each year? He also says a PHI is not needed for me now.

Basically, like those of you who commented in another thread, he has zero worries about me at this point but the antibiotic thing and how often I should stay getting tested is something I would like clarity on.
Posted 1/12/2018 5:06 PM (GMT -5)
It may or may not have been the antibiotics but the important thing is that the PSA came down and that probably rules out cancer. Re the PSA testing frequency, as you know there is much debate on this. I guess if it was me i would do it annually.

Jim
Posted 1/12/2018 6:31 PM (GMT -5)
My 2 cents.....do it every year ....I miss 4 years and during that time my PSA moved up up and away ....my docs gave me anti bio`s for what they thought was BPH....don`t know about that question really....David
Posted 1/12/2018 7:22 PM (GMT -5)

Tudpock18 said...
It may or may not have been the antibiotics but the important thing is that the PSA came down and that probably rules out cancer. Re the PSA testing frequency, as you know there is much debate on this. I guess if it was me i would do it annually.

Jim

Have to agree that the results can't be interpreted one way or the other. The NEW URO must have been asleep during his science classes. To wit:
At least three hypotheses
    Prostatitis (bacterial) and Bactrim was effective
    Prostatitis and Bactrim was ineffective (more likely)
    Prostate cancer; the first PSA could have been up for several reasons


Without further PSA data one does't know...

Post Edited (Sr Sailor) : 1/12/2018 5:39:35 PM (GMT-7)

Posted 1/12/2018 7:40 PM (GMT -5)

Fl Drifter said...
....my docs gave me anti bio`s for what they thought was BPH...

I got longer and longer courses of Cipro, which did improve urinary problems. But my PSA kept going up, so I had a biopsy which 'proved' that I did not have cancer. My Uro only told me that my PSA was higher than ever, but he never explained to what that means. I trusted the wrong doctor.

If antibiotics work but the problem keeps coming back, then the wrong condition is being treated.
Posted 1/13/2018 3:37 AM (GMT -5)
Get it checked annually. My PSA went up and down over a two year period. You want to catch it in the early stages not later after it metasizes. Good luck.
Posted 1/13/2018 4:06 PM (GMT -5)
I agree with your new Uro that the antibiotics probably did nothing. Only about 5% of cases are responsive to antibiotics. Because of antibiotic resistance you are better off waiting it out than taking any. I also agree that if no increase, you can put off the annual PSA . I don't see the benefit to annual PSAs when it is stable. Since you mentioned no risk factors (e.g., family history or African-American), I think following the AUA guidelines of screening starting at 55 is prudent. Ask your Uro what your prostate size is. I do think PHI is a better test, and it includes PSA.
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