Ibuprofen versus fosfomycin for uncomplicated urinary tract infection in women: randomised controlled trial

Abstract

STUDY QUESTIONCan treatment of the symptoms of uncomplicated urinary tract infection (UTI) with ibuprofen reduce the rate of antibiotic prescriptions without a significant increase in symptoms, recurrences, or complications? METHODSWomen aged 18-65 with typical symptoms of UTI and without risk factors or complications were recruited in 42 German general practices and randomly assigned to treatment with a single dose of fosfomycin 3 g (n=246; 243 analysed) or ibuprofen 3×400 mg (n=248; 241 analysed) for three days (and the respective placebo dummies in both groups). In both groups additional antibiotic treatment was subsequently prescribed as necessary for persistent, worsening, or recurrent symptoms. The primary endpoints were the number of all courses of antibiotic treatment on days 0-28 (for UTI or other conditions) and burden of symptoms on days 0-7. The symptom score included dysuria, frequency/ urgency, and low abdominal pain.

Ronda clínica y epidemiológica: club de revistas

“…Es claro que en la presente investigación, aunque se redujo la necesidad total de antibióticos en el grupo de ibuprofeno no se presentó un beneficio sintomático para las pacientes. Además, los casos de pielonefritis fueron más frecuentes en el grupo de ibuprofeno, aunque sin diferencias estadís-ticamente significativas dada su baja ocurrencia (17). Estos resultados no cierran definitivamente la posibilidad de que en las mujeres que presenten síntomas leves o tengan cuadros clínicos dudosos, se considere de común acuerdo la posibilidad de retrasar el inicio del antibiótico e incluso de no prescribirlo en algunos casos.…”

“…De los 4 estudios de bioimpedancia (n = 1039), uno evaluó el Análisis de Impedancia Bioeléctrica (AIB) convencional y 3 estudiaron el Análisis Vectorial de Impedancia Bioeléctrica (AVIB). Cuando se reportaba un AIB segmentario de 54 ohmios o menos, el LR era de 10,6 (IC95 % = 5, [8][9][10][11][12][13][14][15][16][17][18][19]2). Sin embargo, un solo estudio analizó este punto de corte (n = 292) y se consideró que el riesgo de sesgo era muy alto por las exclusiones de los pacientes con base en comorbilidades que causaran ascitis y edema periférico.…”

Women’s health 2016: An update for internists

“…Ibuprofen vs fosfomycin Gágyor et al 6 conducted a double-blind, randomized multicenter trial in 42 general practices in Germany to assess whether treating the symptoms of uncomplicated urinary tract infection with ibuprofen would reduce antibiotic use without worsening outcomes.…”

“…1 Several small studies have suggested that many of these infections are self-limited, resolving within 3 to 14 days without antibiotics ( Table 1). [2][3][4][5][6] A potential disadvantage of withholding treatment is slower bacterial clearance and resolution of symptoms, but reducing the number of antibiotic prescriptions may help slow antibiotic resistance. 7,8 Surveys and quali- On days 0-4, patients in the ibuprofen group had more symptoms than those in the fosfomycin group a Participants in these studies were not pregnant.…”

The Accepted “Clinical Interaction Model”: A Special Case of Reality

“…diclophenac) used for rheumatic diseases have an unexpected antimicrobial activity and are able to cure urinary tract infections [30][31][32].…”