Ibuprofen Found Inferior to Antibiotics for Uncomplicated Urinary Tract Infection

By Joe Elia

Edited by Lorenzo Di Francesco, MD, FACP, FHM

Women with uncomplicated urinary tract infection (UTI) do better on an antibiotic than on ibuprofen — contrary to other recent findings — according to a report in PLOS Medicine.

In a noninferiority study, investigators randomized some 400 women with symptoms of uncomplicated UTI to 3 days' treatment with either ibuprofen or pivmecillinam (an antibiotic not approved in the U.S.). The outcome of interest was self-report of feeling cured by day 4.

Roughly 40% of the ibuprofen group reported cure by day 4, while about 75% of those on antibiotics did. That 35% difference fell outside the researchers' predefined margin of noninferiority (10%), and they concluded that ibuprofen was inferior to the antibiotic regimen.

Although use of ibuprofen could reduce unnecessary use of antibiotics, the authors conclude that "until we can identify those women in need of antibiotic treatment to prevent complications, we cannot recommend ibuprofen alone to women with uncomplicated UTIs."