Ibuprofen versus pivmecillinam for uncomplicated urinary tract infection in women-A double-blind, randomized non-inferiority trial

PLoS Medicine
Ingvild VikMorten Lindbæk

Abstract

Although uncomplicated urinary tract infections (UTIs) are often self-limiting, most patients will be prescribed antibiotic treatment. We assessed whether treatment with ibuprofen was non-inferior to pivmecillinam in achieving symptomatic resolution by day 4, with a non-inferiority margin of 10%. This was a randomized, controlled, double-blind non-inferiority trial. We recruited patients from 16 sites in a general practice setting in Norway, Sweden, and Denmark. Non-pregnant women aged 18-60 years presenting with symptoms of uncomplicated UTI were screened for eligibility from 11 April 2013 to 22 April 2016. Patients with informed consent were randomized (1:1 ratio) to treatment with either 600 mg ibuprofen or 200 mg pivmecillinam 3 times a day for 3 days. The patient, treating physician, and study personnel were blinded to treatment allocation. The primary outcome was the proportion of patients who felt cured by day 4, as assessed from a patient diary. Secondary outcomes included the proportion of patients in need of secondary treatment with antibiotics and cases of pyelonephritis. A total of 383 women were randomly assigned to treatment with either ibuprofen (n = 194, 181 analyzed) or pivmecillinam (n = 189, 178 analyzed). By...Continue Reading

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Citations

Jul 15, 2020·Nature Reviews. Urology·Livia Lacerda Mariano, Molly A Ingersoll
Feb 2, 2021·Infectious Diseases·Adi TurjemanDafna Yahav
Dec 31, 2020·Antibiotics·Oghenekome A GbinigieChristopher C Butler
May 8, 2021·Life Science Alliance·Tahmineh EbrahimzadehNicole J De Nisco
Jun 11, 2021·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Ildikó GágyorJutta Bleidorn
Sep 21, 2021·The Journal of Antimicrobial Chemotherapy·Ildikó Gágyor, Alastair D Hay
Nov 24, 2021·JAMA : the Journal of the American Medical Association·Dimitri M DrekonjaJames R Johnson
Nov 24, 2021·JAMA : the Journal of the American Medical Association·Joel Goldberg, John H Powers
Dec 14, 2021·Journal of Global Antimicrobial Resistance·Florian WagenlehnerSeung-Ju Lee

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