Efficacy of Nonsteroidal Anti-inflammatory Drugs for Treatment of Uncomplicated Lower Urinary Tract Infections in Women: A Meta-analysis

Urinary tract infections (UTIs) are among the most frequent causes for antibiotic prescription and; therefore, alternative treatment options for UTIs can potentially reduce antibiotic usage and development of resistance. To evaluate the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDS) for the treatment of uncomplicated lower UTIs in women, this study implemented a meta-analytic approach to evaluate the results of available randomized clinical studies from online databases. A total of four trials involving 1144 patients with uncomplicated lower UTIs were included in the final evaluation. Results showed that symptom resolution at Day 3-4 in the NSAIDs group was significantly lower than that in the antibiotics group [pooled odds ratio (OR) = 0.41, 95% confidence interval (CI): 0.23-0.74, P < 0.05]. However, there was no significant difference between the NSAIDs and antibiotics groups in symptom resolution at Day 7 (pooled OR = 0.43, 95% CI: 0.17-1.06, P = 0.07), secondary antibiotic treatment rate at Day 28-30 (pooled OR = 1.15, 95% CI: 0.16-7.98, P = 0.89) and adverse events rate (pooled OR = 1.09, 95% CI: 0.61-1.96, P = 0.77). Therefore, this meta-analysis suggests that, although inferior to antibiotics in fast symptom resolution, symptomatic treatment with NSAIDs can be considered as an alternative treatment option for uncomplicated lower UTIs in women. However, given the low number of randomized controlled trials that met inclusion criteria in this meta-analysis, efficacy of NSAIDs for treatment of uncomplicated lower UTIs should be further evaluated in more comprehensive clinical studies.