The increase in water consumption reduces recurrent urinary tract infections in women

The researchers found that women who drank 1.5 liters of water more than their usual fluid intake significantly reduced their risk of repeated bladder infections.

Yair Lotan, MD, of the Southwestern Medical Center at the University of Texas at Dallas, reports women who increase their water intake and have 48% fewer recurrent bladder infections than women who consumed their usual volume of fluids .

"The fact is that people are doing a lot of different things that are expensive – and have side effects – to try to reduce the risk of recurrent infection," Lotan said. "And in this study, drinking water – which is a very easy intervention – has resulted in a very significant reduction of these infections in healthy women, which is very good news."

And this is good news, given that women are a particularly vulnerable group for bladder infections, with data suggesting that they are at a risk of over 50% developing uncomplicated acute cystitis during their lifetime. life.

In addition, this study (funded by Danone, which sells bottled water) found that 27% of women with their first episode of cystitis will see it reproduce within 6 months.

In this controlled, randomized, 12-month, open-label trial, published online in JAMA Internal Medicine140 healthy women with recurrent cystitis (with at least three episodes in the previous year) who reported drinking less than 1.5 liters of water a day were assigned to one group of water (additional consumption of 1.5 liters of water compared to normal) intake) or a control group (no additional fluid consumption).

The study participants had an average age of 35.7 years and had experienced an average of 3.3 episodes of cystitis during the previous year.

The researchers evaluated daily fluid intake, urinary hydration and cystitis infections at the start of treatment, at 6 and 12 months and by monthly phone calls. The primary endpoint was the frequency of recurrent cystitis over 12 months.

During the 12-month study period, women in the Water group were able to significantly reduce their mean number of episodes of cystitis to 1.7 (95% CI 1.5-1, 8), compared to 3.2 episodes (95% CI 3.0-3.4) in the control group. group. In total, there were 327 episodes of cystitis, the vast majority (216) of which were in the control group.

"Of course, when you do a randomized trial, you never know if you will see a profit," Lotan said. MedPage today. "We thought emptying the bladder and diluting the bacteria would reduce the risk of infection, but I do not think we expected it to have such a big impact."

The secondary results of the study included the average number of antimicrobial regimens used to treat episodes of cystitis (1.9 in the water group versus 3.6 in the control group) and the mean delay between cystitis episodes (142, 8 days in the water group versus 84.4 in the control group). control group). The researchers also determined that participants in the Water group increased their 24-hour urine volumes by 1.3 liters during the study period, compared to 0.1 liters in the group. witness.

"It seems appropriate for clinicians who advise healthy women with recurrent cystitis to routinely ask questions about daily fluid intake and recommend increased water consumption, especially for those who do not drink more. 1.5 L of fluids per day, as a safe and inexpensive alternative to strategies that use antimicrobials ", concluded the Lotan Group.

Said Lotan MedPage today that if almost all fluids other than water would probably have the same effect of producing more urine and dilutive bacteria, these options are unlikely to be as healthy as water: "It will be very difficult to drink liter and a half of any other fluid that will not have side effects – for example, juices will have a lot of sugar in them. "

He suggested that future research focuses on antibiotic resistance, which has become a growing problem even for bladder infections. "If we can prevent infections, it's quite possible that we can reduce patterns of resistance, and that would be an important finding."

• Reviewed by
  Dori F. Zaleznik, MD Associate Professor of Clinical Medicine (Retired), Harvard Medical School, Boston and Dorothy Caputo, MA, BSN, Nurse Planner

2018-05-10T00: 00: 00-0400

Last update 05/10/2018