Cystitis Recurrence Reduced with Water Intake

Increasing daily water intake helps to protect against recurrent cystitis in premenopausal women with low daily fluid intake, according to a recent study.

While increased hydration is often recommended to women with recurrent cystitis, data supporting these recommendations are sparse, according to the researchers.

To further explore this relationship, they conducted a randomized, open-label, controlled, 12-month trial involving 163 women with recurrent cystitis (3 or more episodes in the past year) who were drinking less than 1.5 L of fluid a day. Of these, 23 were excluded from the analysis and 140 were assigned to either the water (1.5 L of water daily, in addition to usual consumption) or control group. Fluid intake, urinary hydration, and cystitis symptoms were assessed at baseline, 6 months, and 12 months, as well as through monthly telephone calls.

During the study period, the mean number of cystitis episodes was 1.7 in the water group compared with 3.2 in the control group. Overall, 327 cystitis episodes were observed, 111 in the water group and 216 in the control group. In the group drinking more water and the control group, the mean number of antimicrobial regimens used to treat cystitis was 1.9 and 3.6 and the mean time interval between cystitis episodes was 142.8 and 84.4 days, respectively.

“Our data confirm the benefit of increased water intake in reducing the risk of recurrent cystitis in women with a history of frequent recurrent cystitis who are low-volume fluid drinkers,” they concluded.

“[I]t seems appropriate for clinicians who counsel healthy women with recurrent cystitis to routinely ask about daily fluid intake and to recommend increased intake of water, especially in those who drink no more than 1.5 L of fluids daily, as a safe and inexpensive alternative to strategies that employ antimicrobials.”

—Michael Potts

Reference:

Hooton TM, Vecchio M, Iroz A, et al. Effect of increased daily water intake in premenopausal women with recurrent urinary tract infections [published online October 1, 2018. JAMA Intern Med. doi:10.1001/jamainternmed.2018.4204