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Uncomplicated urinary tract infections (UTIs) account for 25% of antibiotic prescriptions in general practice. Most UTIs are self-limiting, meaning symptomatic treatment could provide an alternative to antibiotics.
Researchers from Germany randomly assigned 494 women with symptoms of an uncomplicated UTI to a single 3g dose of fosfomycin (n=243) or 3x400mg doses of ibuprofen (n=241) over three days.
Two-thirds of women given ibuprofen recovered without the need for antibiotics. The remaining 85 women required 94 courses of antibiotics — a much lower figure than the 283 courses in the antibiotic group. However, there was a higher symptom burden and a higher rate of pyelonephritis (2.0% vs 0.4%) in women assigned to ibuprofen.
The researchers conclude in The
BMJ (online, 23 December 2015)[1]
that ibuprofen could be an option for some women with mild to moderate symptoms or used with a delayed prescription.
References
[1] Gágyor I, Bleidorn J, Kochen MM et al. Ibuprofen versus fosfomycin for uncomplicated urinary tract infection in women: randomised controlled trial. The BMJ 2015;351:h6544. doi: 10.1136/bmj.h6544.
