Uncomplicated lower urinary tract infection (UTI) is an infection in the bladder and urethra. Non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics are both used as the first-line treatment for uncomplicated UTIs, but their effectiveness is not well-studied. This study aims to analyze the efficacy of symptomatic treatment of uncomplicated lower UTIs with NSAIDs in comparison with the regular antibiotics.
This double-blind, non-inferiority, randomized trial included a total of 253 women with uncomplicated lower UTI. The patients were randomly assigned in a 1:1 ration to symptomatic treatment with diclofenac (NSAID) (n=133) or antibiotic treatment with norfloxacin (n=120). The primary outcome of the study was the resolution of symptoms 74 hours after randomization.
The findings suggested that symptomatic resolution occurred in 72 women (54%) in the diclofenac group and 96 (80%) in the norfloxacin group on day 3. The median time until resolution of symptoms was higher in the diclofenac group (4 days), as compared with the norfloxacin group (2 days). 62% of women in the diclofenac group and 98% in the norfloxacin group continued treatment for 30 days. Six patients (5%) in the diclofenac group suffered from pyelonephritis.
The research concluded that diclofenac was inferior to norfloxacin for symptomatic resolution. In addition, diclofenac was also associated with an increased risk of pyelonephritis.