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Uva-ursi extract and ibuprofen as alternative treatments for uncomplicated urinary tract infection in women (ATAFUTI): a factorial randomized trial

Moore, M; Trill, J; Simpson, C; Webley, F; Radford, M; Stanton, L; Maishman, T; ... Griffiths, G; + view all (2019) Uva-ursi extract and ibuprofen as alternative treatments for uncomplicated urinary tract infection in women (ATAFUTI): a factorial randomized trial. Clinical Microbiology and Infection 10.1016/j.cmi.2019.01.011. (In press). Green open access

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Abstract

OBJECTIVES: To investigate if offering symptomatic therapy (Uva-ursi or ibuprofen) alongside a delayed prescription would relieve symptoms and reduce the consumption of antibiotics for adult women presenting with acute uncomplicated urinary tract infection (UTI). METHODS: A 2x2 factorial placebo controlled randomised trial in primary care. Participants: 382 women aged 18-70 with symptoms of dysuria, urgency or frequency of urination and suspected by a clinician to have a lower UTI. Interventions: Uva-ursi extract and/or Ibuprofen advice. All women were provided with a delayed or ‘back-up’ prescription for antibiotics. Missing data were imputed using multiple imputation methods. ISRCTN registry: ISRCTN43397016. RESULTS: An ITT analysis of mean score for frequency symptoms assessed on day 2-4 found no evidence of a difference between Uva-ursi vs. placebo -0·06 (95% CI -0·33 to 0·21) p=0·661, nor ibuprofen vs. no ibuprofen advice -0·01 (95% CI -0·27 to 0·26) p=0·951. There was no evidence of a reduction in antibiotic consumption with Uva-ursi (39·9% vs. placebo 47·4%; logistic regression odds ratio (OR) 0·59 (95% CI 0·22 to 1·58) p=0·293) but there was a significant reduction for ibuprofen advice (34·9% vs. no advice 51·0%; OR 0·27 (95% CI 0·10 to 0·72) p=0·009). There were no safety concerns and no episodes of upper tract infection were recorded. CONCLUSIONS: We found no evidence of an effect of either intervention on the severity of frequency symptoms. There is evidence that advice to take ibuprofen will reduce antibiotic consumption without increasing complications. For every seven women given this advice, one less will use antibiotics.

Type: Article
Title: Uva-ursi extract and ibuprofen as alternative treatments for uncomplicated urinary tract infection in women (ATAFUTI): a factorial randomized trial
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.cmi.2019.01.011
Publisher version: https://doi.org/10.1016/j.cmi.2019.01.011
Language: English
Additional information: Copyright © 2019 The Authors. Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: Antibiotic resistance, Urinary tract infection, Uva-ursi, NSAID, ibuprofen
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10066106
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