NSAIDs Less Effective Than Antibiotics for UTI

NSAIDs are less effective than antibiotics for symptom control in uncomplicated UTI, a research has found. Patients with uncomplicated UTIs taking NSAIDs instead of antibiotics were more averse to experience early symptom determination and had an increased risk of pyelonephritis. The study carried out by scientists at the University of Bern, Switzerland, included just over 250 Swiss women who presented to their GP with symptoms of an acute UTI. About half of the women were prescribed with diclofenac and half were prescribed with norfloxacin.

Resolution of symptoms at day three was seen in 80% of the norfloxacin group, however just 54% of the diclofenac group. The women were given a rescue antibiotic, fosfomycin, to use after day three at their discretion if symptoms persisted, which was taken in the initial three days by 41% of the women prescribed diclofenac and only 8% of the women taking norfloxacin. There were likewise six cases of clinically diagnosed pyelonephritis in the diclofenac group, compared with none in the norfloxacin group.

‘Our outcomes in women with uncomplicated lower UTI are well in line with the prolongation of symptoms observed with symptomatic treatment of these conditions. The same number of women in the diclofenac group resorted to antibiotic treatment in our trial, a procedure of selectively deferring rather than completely withholding antibiotic treatment might be preferable for uncomplicated lower UTI said by the researchers in the paper.

‘This can be achieved through a shared decision-making process, during which clinicians ask about their patients’ expectations and ideas about antibiotic treatment for uncomplicated UTI and furthermore explore the option of delaying antibiotic use as a treatment strategy.’

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