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GPs should consider ibuprofen over antibiotic in UTI, suggests study



GPs can consider offering an initial course of ibuprofen to women with uncomplicated urinary tract infection, instead of prescribing an antibiotic, researchers have claimed.

The German team found nearly two-thirds of women who were given ibuprofen to help ease the symptoms of a urinary tract infection (UTI) recovered without resorting to antibiotics.

The study, published in the BMJ, included 248 women with typical UTI symptoms, half of whom took ibuprofen three times a day for three days, while the other half took a daily dose of the antibiotic fosfomycin for three days.

Of the 241 women who took ibuprofen to start with, 156 (65%) recovered without subsequently needing antibiotic treatment during a month of follow-up, and, overall, the ibuprofen group used 65% fewer antibiotics than the fosfomycin group.

However, although symptoms mostly cleared up within a week in both groups, on average the women who took ibuprofen had worse symptoms than those who took the antibiotic initially. They also suffered more complications during follow-up – with five cases of pyelonephritis in the ibuprofen group compared with one in the fosfomycin.

The researchers concluded that they ‘cannot generally recommend’ giving ibuprofen, but that the approach ‘can be discussed with women with mild to moderate symptoms in a shared decision making approach or within a strategy of delayed prescription’.

The team added that this ‘has the potential to considerably reduce the number of antibiotic prescriptions for women with mild to moderate symptoms of urinary tract infections’.