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Primary care
Pivmecillinam is more effective than ibuprofen in symptom resolution in women with uncomplicated urinary tract infection: antibiotic treatment for UTI is important
  1. Jutta Bleidorn
  1. Department of General Practice, Medical School Hannover, Hannover, Germany
  1. Correspondence to Dr Jutta Bleidorn, Department of General Practice, Medical School Hannover, Germany; bleidorn.jutta{at}

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Commentary on: Vik I, Bollestad M, Grude N, et al. Ibuprofen versus pivmecillinam for uncomplicated urinary tract infection in women—a double-blind, randomized non-inferiority trial. PLoS Med. 2018;15:e1002569.


Uncomplicated urinary tract infection (UTI) is a common condition, and many affected women are treated with antibiotics. However, since complications are rare, the main treatment goal is to reduce symptoms.1 Several trials indicate that many patients recover with symptomatic treatment or delayed prescription,2 3 and reducing avoidable antibiotic prescriptions gains in importance to decrease resistance development.4 5 Against this background, Vik et al conducted this randomised controlled trial to assess non-inferiority of symptomatic treatment of uncomplicated UTI.6 Nearly simultaneously, similar trials assessed fosfomycin versus ibuprofen7 respectively norfloxacin versus diclofenac8 in treatment of uncomplicated UTI.


To assess whether …

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  • Contributors This commentary was drafted by JB.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.