Re: Ibuprofen versus fosfomycin for uncomplicated urinary tract infection in women: randomised controlled trial
I read with interest the article by Gágyor I, Bleidorn J, Kochen MM et al. Ibuprofen versus fosfomycin for uncomplicated urinary tract infection in women: randomised controlled trial (BMJ 2015;351:h6544), but I am wondering why the authors haven’t taken into consideration that Ibuprofen is a non-antibioticum (1, 2) and that it has antimicrobial activity like many other non-antibiotics. If note of the non-antibiotic activity was made in the protocol and results sections, then this would have led to a clearer understanding of the observed beneficial effects of ibuprofen described in the conclusions. The use of ibuprofen for ‘symptomatic treatment’ implies that one is relying on its ‘painkiller’ activity whereas in practice it may well be that it is the broad spectrum antimicrobial activity of ibuprofen that is the most significant. In particular the possibility for microbial resistance development again ibuprofen should also be discussed, even it is “only” used as painkiller in UVI investigation.
The antimicrobial activity of the large and diverse groups of non-antibiotics is unfortunately often overlooked when treating patients suffering fromnon-infectious diseases. Regrettably, it is not mandatory to mention these antimicrobial “side effects” in the information materials supplied, even though they might be positive.
1. Kristiansen JE. 1991. Antimicrobial activity of nonantibiotics. ASM News 57:135–139.
2. Jelena Obada, Jagoda Šuškovićb, Blaženka Kosb. Antimicrobial activity of ibuprofen: New perspectives on an “Old” non-antibiotic drug. European Journal of Pharmaceutical Sciences Volume 71, 25 April 2015, Pages 93–98
Competing interests: No competing interests