AINE: ¿una alternativa a los antibióticos en el tratamiento de las infecciones urinarias en las mujeres? Una revisión basada en la evidencia

Abstract

Introduction

Urinary tract infections (UTIs) remain a major cause of morbidity in otherwise healthy women. It is estimated at least 50% of women will have at least 1 UTI in their lifetime. Current guidelines recommend the use of antibiotics (ABs) for treatment, constituting the 2 nd most common reason for their prescribing. However, antibiotic resistance remains a worrying problem, therefore it is almost imperative to find alternatives for UTIs. One of the most suggested alternatives are Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Some clinical trials have shown that these are similar to ABs in resolving urinary symptoms.

Objectives

To evaluate the NSAIDs’ effectiveness in the treatment of uncomplicated UTIs in healthy, non-pregnant women and to prove their non-inferiority to ABs.

Methods

This evidence-based review study encompasses articles published between January 2010 and December 2021, in the medical databases, using the keywords MeSH: “NSAIDs”, “UTI” and “Treatment”. The Strength of Recommendation Taxonomy scale was used to classify the level of evidence.

Results

There were 8 articles selected and the majority concluded ABs are superior in the treatment of UTIs, as the clinical condition resolved more quickly. However, it considered NSAIDs also demonstrated effectiveness. Furthermore, it was also found that treatment with NSAIDs didn’t present as greater risk of complications.

Conclusion

ABs remain the most preferred therapy for treating UTIs and there is not yet sufficient evidence to support the use of NSAIDs. However, more studies are needed to evaluate its effectiveness in resolving UTIs’ symptomatology. This may be an opportunity to reduce the prescription of ABs.