Intended for healthcare professionals

Letters Ibuprofen v fosfomycin for uncomplicated urinary tract infection

Non-antibiotic effects of ibuprofen in uncomplicated urinary tract infection in women

BMJ 2016; 352 doi: (Published 02 March 2016) Cite this as: BMJ 2016;352:i1171
  1. Jette E Kristiansen, senior researcher
  1. Memphys (Centre for Biomembrane Physics), University of Southern Denmark, DK-5230 Odense M, Denmark
  1. malthe{at}

I wonder why in their comparison of ibuprofen and fosfomycin for uncomplicated urinary tract infection Gágyor and colleagues did not take into account the fact that ibuprofen is a non-antibiotic,1 2 3 and that it has antimicrobial activity like many other such drugs. Mention of this in the protocol and results sections would have led to a clearer understanding of the observed benefits of ibuprofen described in the conclusions. The use of ibuprofen for “symptomatic treatment” implies that its analgesic activity is most important, whereas in practice its broad spectrum antimicrobial activity might be the most important factor. The possibility of the development of microbial resistance to ibuprofen should have been discussed, even it was used “only” as a painkiller in the investigation.

The antimicrobial activity of the large and diverse groups of non-antibiotics is often overlooked when treating patients with non-infectious diseases. Unfortunately, it is not mandatory to mention these antimicrobial “side effects” in the information supplied, even though they might have positive effects.


  • Competing interests: None declared.


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