Effect of levofloxacin treatment on semen hyperviscosity in chronic bacterial prostatitis patients

Summary Changes in seminal fluid viscosity ( SFV ), reactive oxygen species ( ROS ) production, cytokines and seminal leucocyte concentration related to microbiological outcome in patients with chronic bacterial prostatitis ( CBP ) were studied. One hundred and ten infertile patients with CBP (positive sperm culture ≥10 5 colony‐forming units [ CFU ] ml −1 , pathogens or Chlamydia in expressed prostatic secretions) were treated with levofloxacin 500 mg daily for 14 consecutive days per month for 3 months. In case of bacterial prostatitis, two conditions were examined: responders, eradication of 0 to <10 3  CFU ml −1 ( n  = 78) and poor responders, >10 3 to <10 5  CFU ml −1 ( n  = 32). Compared with poor responders, responders showed a significant increase of sperm progressive motility and a significant decrease in seminal leucocyte count, SFV , liquefaction time, ROS production (in all fractions and conditions), seminal tumour necrosis factor‐α and interleukin 6. None of these variables showed significant differences compared with a control group of 37 fertile men. On the other hand, the poor responders showed significant changes in these variables compared with matched pretreatment values. In patients with CBP , antibiotic therapy alone leads to eradication in ≈71%, with improvement of sperm progressive motility, SFV and the framework of prooxidative factors. However, in the remaining ≈29% with poor antibiotic responsiveness, a deterioration of all variables is observed.