Table 1 Study characteristics of NSAID versus Antibiotic use in Uncomplicated UTI

Bleidorn, 2010

Multicenter, double-blinded, RCT, pilot trial, Germany

Non-pregnant women aged 18–85 y/o, with uncomplicated UTI

At least one of the main UTI symptoms dysuria and frequency

Signs of upper UTI symptoms (fever, back pain)

Pregnancy

Comorbidities: DM, CKD

GIT abnormalities or past urinary surgery, Urine catheterization, immunosuppressive therapy

UTI within the last two weeks

Current use of antibiotics or NSAIDs;

History of GI ulcers

Epilepsy

Allergies

Ibuprofen vs Ciprofloxacin

Primary: Symptom resolution on Day 4

Secondary: Burden of symptoms on Day 4 and, symptom resolution on Day 7 and frequency of relapses until Day 28, and incidence of adverse events

Gagyor, 2015

Multicenter, double-blinded, RCT, Germany

Non-pregnant women aged 18–65 y/o, with uncomplicated UTI

Dysuria and/or frequency/urgency of micturition, with or without lower abdominal pain

Any signs of upper UTI (fever, loin tenderness);

Pregnancy

Renal diseases

UTI within the past two weeks

Urinary catheterization. Recent NSAID or antibiotics use

History of GI ulcers or severe acute or exacerbated chronic conditions

Ibuprofen vs Fosfomycin

Primary: Number of all courses of antibiotic treatment on Day 0–28, Burden of symptoms on Day 0 to 7

Secondary: Number of severe adverse events, complications, relapses up to Day 28, and within 6 and 12 months, women without symptoms at day 4 and 7, symptom load until Day 4, activity impairment on Day 1–7

Kronenberg, 2017

Multicenter, double-blinded, RCT, Switzerland

Non-pregnant women aged 18–70 y/o, with uncomplicated UTI

One or more symptoms or signs typical of acute lower UTI (dysuria, frequency, macrohematuria, cloudy or smelly urine) or self-diagnosed symptomatic cystitis (urine dipstick was positive for nitrite or leucocytes, or both)

Pregnant women and women

Signs of upper UTI: (fever, costovertebral pain or tenderness, rigors, and nausea or vomiting)

GIT abnormalities

Comorbidities (DM, GI ulcer, IBD, liver cirrhosis, CKD, CHF)

Psychiatric illness or dementia

Documented immunosuppression

Hypersensitivity reactions

Women with vaginal symptoms (discharge, irritation)

Bladder catheterization

Recurrent UTI

Antibiotic treatment during the past four weeks

UTI symptoms > 7 days

Diclofenac vs Norfloxacin

Primary: Resolution of symptoms at day 3

Secondary: Use of any antibiotic up to Day 30, resolution of symptoms on Day 7, complete absence of symptoms on Days 3 and 7, use of rescue antibiotic up to Day 3, negative urine culture result on Day 10, reconsultations because of UTI up to day 30, adverse events, serious adverse events, European quality of life.

Vik, 2018

Multicenter, double-blinded, noninferiority, RCT, Norway, Denmark, Sweden

Non-pregnant women aged 18–60 y/o, with uncomplicated UTI

Dysuria combined with either increased urinary frequency or urinary urgency or both, with or without visible hematuria

Signs of upper UTI (fever, upper back pain)

UTI symptoms for > 7 days

Allergies/adverse reactions to penicillin or ibuprofen

Breastfeeding a child under 1 month of age

Vaginal irritation/discharge

Comorbids: diabetes; kidney disease; genetic aciduria; severe gastritis; ulcerative colitis; Crohn’s disease; low platelets);

Immunosuppressive therapy, or blood-thinning drugs

Previous pyelonephritis

Urinary catheterization

Symptoms of a UTI within the last 4 weeks

Antibiotic use within the last 2 weeks

Ibuprofen vs Pivmecillinam

Primary: Proportion of patients who felt cured by Day 4

Secondary: Proportion of patients in need of secondary treatment with antibiotics, proportion of patient with positive second urine culture, in need of a medical consultation within 4 weeks of follow-up, cases of pyelonephritis