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Antibiotics may be better than NSAIDs to treat urinary tract infections

Treating the symptoms of uncomplicated lower urinary tract infections with non-steroidal anti-inflammatory drugs may be inferior to antibiotic treatment, research suggests

Treating the symptoms of uncomplicated lower urinary tract infections (UTI) with non-steroidal anti-inflammatory drugs (NSAIDs) may be inferior to antibiotic treatment, research suggests.

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Researchers from the University of Bern in Switzerland studied 253 women aged between 18 and 70 with uncomplicated UTIs from 17 general practices.

A total of 133 women were randomly assigned to be treated with the NSAID diclofenac and 120 with the antibiotic norfloxacin.

Antibiotic prescriptions for UTIs account for 10-20% of all antibiotic prescriptions in ambulatory care and are second only to antibiotic prescriptions for respiratory tract infections, researchers say.

Lower patient satisfaction

The women treated with diclofenac, which is also likely to be associated with an increased risk of pyelonephritis, were 27% less likely to have symptom resolution at day three and 12% less likely at day seven than those being treated with the antibiotic.

The Swiss study, published in the British Medical Journal, was one of two randomised double blind trials initiated in 2012 in Switzerland and Germany comparing NSAIDs with antibiotics for the treatment of UTIs.

The women treated with diclofenac in the study were also found to be likely to have more frequent further consultations, a higher incidence of diagnosed pyelonephritis and lower patient satisfaction than the norfloxacin group.


Kronenberg A et al (2017) Symptomatic treatment of uncomplicated lower urinary tract infections in the ambulatory setting: randomised, double blind trial. BMJ. doi: https:// doi.org/10.1136/bmj.j4784 

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