Taking ibuprofen can make the agony of cystitis worse

WOMeN battling cystitis may be making it worse by taking ibuprofen for the symptoms.

The common painkiller can make a urinary tract infection last three days longer and increases the risk of a kidney infection, a study has found.

More than half of women suffer a UTI such as cystitis during their lifetime, with one in five enduring recurrent infections.

After doubt was cast last week on cranberry juice’s ability to tackle the problem, evidence now suggests ibuprofen is also the wrong approach. The study of almost 400 women found those given the over-thecounter drug without antibiotics took longer to get better. They were around half as likely to have recovered by day four of the illness. Among the 181 given ibuprofen, seven developed a kidney infection and five were hospitalised.

Antibiotics are known to cut a bladder infection short and provide quick relief from the symptoms, which include pain, fatigue and an urgent need to urinate. But the advice on the NHS Choices website is still that it is possible to treat the symptoms at home, taking ibuprofen while drinking lots of water.

The authors of the latest study, led by Ingvild vik at the University of Oslo, say many women given ibuprofen do improve without further treatment. But they add: ‘Until we can identify those women in need of antibiotic treatment to prevent complications, we cannot recommend ibuprofen alone to women with uncomplicated UTIs.’

UTIs are the second most common reason that GPs prescribe antibiotics. However, previous studies have suggested up to two thirds of female sufferers could recover by simply taking ibuprofen instead.

To test this, researchers split 383 patients aged 18 to 60 into two groups and gave them either ibuprofen or the common antibiotic pivmecillinam. The drugs were contained in red capsules of the same weight and taken three times a day for three days.

Only 39 per cent of women taking the painkiller were better by day four, compared to 74 per cent of those taking the antibiotic.

Within a fortnight, more than 40 per cent of women given ibuprofen had gone back to the doctor still in pain, compared to fewer than 10 per cent of the group on antibiotics. Twelve of those taking ibuprofen developed a more serious upper urinary tract infection, causing fever and pain in their side. No patients taking antibiotics developed kidney infections, but seven of those given painkillers did.

The study did find more than half of patients treated with ibuprofen got better without antibiotics but expressed concern over possible side effects. The study, published in the journal PLOS Medicine, concluded that antibiotic treatment was the best treatment for an uncomplicated urinary tract infection.

Dr vik said: ‘However, a large amount of women did get well without antibiotic treatment, and we believe that for women with milder symptoms a wait-and-see strategy can be discussed.

‘These women should start taking antibiotics if they do not recover within a few days.’

Health watchdog Nice recommends ibuprofen for managing the pain of a UTI but does not do so as a replacement for antibiotics.