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)
that ibuprofen could be an option for some women with mild to moderate symptoms or used with a delayed prescription.
 GÃ¡gyor 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.