Evidence map›Paper›PMID 26698878›Full record

Trial reportBMJ (Clinical research ed.)2015

Ibuprofen versus fosfomycin for uncomplicated urinary tract infection in women: randomised controlled trial.

Ildikó Gágyor, Jutta Bleidorn, Michael M Kochen, Guido Schmiemann, Karl Wegscheider, Eva Hummers-Pradier

2 registry-linked trialsOpen access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 125 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
125citing papers in PubMed, 8 pooled it
18.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01488955 phase4completednot on this map

Immediate vs. Conditional Use of Antibiotics in Uncomplicated Urinary Tract Infection (UTI) - a Comparative Effectiveness Study in General Practice (ICUTI)

TypeinterventionalSponsorInstitut fuer anwendungsorientierte Forschung und klinische Studien GmbHRan2012 to 2014Enrolled494ConditionsUrinary Tract InfectionArmsIbuprofen, Fosfomycin-Trometamol
NCT03633994 phase2unknown statusnot on this mapstarted 2018, after this paper: background citation

Heparin Intraoperative Instillation for Lower Urinary Tract Symptoms After Benign Hysterectomy: A Randomized Controlled Trial

TypeinterventionalSponsorThe Christ HospitalRan2018 to 2020Enrolled104ConditionsLower Urinary Tract Symptoms, Postoperative Urinary Tract InfectionArmsHeparin, Normal saline
3 · Its place in the literature

Who cites it

125 citing papers in PubMed, 8 syntheses or guidelines pooled it, 299 citations in OpenAlex.

  1. Pooled it
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  4. Increased fluid intake to prevent urinary tract infections: systematic review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020
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  7. Guideline
  8. Implications of Antibiotic Resistance for Patients' Recovery From Common Infections in the Community: A Systematic Review and Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017
    Pooled it
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  16. Improving pain management in childhood acute otitis media in general practice: a cluster randomised controlled trial of a GP-targeted educational intervention.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020
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65 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 1 country.

Ildikó GágyorDepartment of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073 Göttingen, Germany igagyor@gwdg.de.
Jutta BleidornInstitute of General Practice, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
Michael M KochenDepartment of Medicine, Division of General Practice, University Medical Centre, Elsässerstrasse 2m, 79110 Freiburg, Germany.
Guido SchmiemannInstitute for Public Health and Nursing Research, Department for Health Services Research, University of Bremen, Grazer Strasse 4, 28359 Bremen, Germany.
Karl WegscheiderDepartment of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
Eva Hummers-PradierDepartment of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073 Göttingen, Germany.
Universitätsmedizin Göttingen · DEMedizinische Hochschule Hannover · DEUniversity Medical Center Freiburg · DEUniversity Medical Center Hamburg-Eppendorf · DEUniversity of Bremen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

study questionCan treatment of the symptoms of uncomplicated urinary tract infection (UTI) with ibuprofen reduce the rate of antibiotic prescriptions without a significant increase in symptoms, recurrences, or complications?

methodsWomen aged 18-65 with typical symptoms of UTI and without risk factors or complications were recruited in 42 German general practices and randomly assigned to treatment with a single dose of fosfomycin 3 g (n=246; 243 analysed) or ibuprofen 3 × 400 mg (n=248; 241 analysed) for three days (and the respective placebo dummies in both groups). In both groups additional antibiotic treatment was subsequently prescribed as necessary for persistent, worsening, or recurrent symptoms. The primary endpoints were the number of all courses of antibiotic treatment on days 0-28 (for UTI or other conditions) and burden of symptoms on days 0-7. The symptom score included dysuria, frequency/urgency, and low abdominal pain. STUDY ANSWER AND LIMITATIONS: The 248 women in the ibuprofen group received significantly fewer course of antibiotics, had a significantly higher total burden of symptoms, and more had pyelonephritis. Four serious adverse events occurred that lead to hospital referrals; one of these was potentially related to the trial drug. Results have to be interpreted carefully as they might apply to women with mild to moderate symptoms rather than to all those with an uncomplicated UTI. WHAT THIS PAPER ADDS: Two thirds of women with uncomplicated UTI treated symptomatically with ibuprofen recovered without any antibiotics. Initial symptomatic treatment is a possible approach to be discussed with women willing to avoid immediate antibiotics and to accept a somewhat higher burden of symptoms. FUNDING, COMPETING INTERESTS, DATA SHARING: German Federal Ministry of Education and Research (BMBF) No 01KG1105. Patient level data are available from the corresponding author. Patient consent was not obtained but the data are anonymised and risk of identification is low.Trial registration No ClinicalTrialGov Identifier NCT01488955.

Indexed as

AdolescentAdultAgedAnti-Bacterial AgentsAnti-Inflammatory Agents, Non-SteroidalFemaleFosfomycinHumansIbuprofenMiddle AgedRecurrenceTime FactorsTreatment OutcomeUrinary Tract InfectionsYoung AdultAnti-Bacterial AgentsAnti-Inflammatory Agents, Non-SteroidalFosfomycinIbuprofen

Identifiers

PMID26698878
PMCPMC4688879
OpenAlexW2216177570

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.