POEMs
Patient-Oriented Evidence That Matters
Increased Water Intake Decreases UTI Recurrence in Women
Am Fam Physician. 2019 Mar 15;99(6):online.
Clinical Question
Does increased water intake decrease urinary tract infection (UTI) recurrence in women?
Bottom Line
Drinking an additional 1.5 liters per day of water halved the recurrence of UTI in women with a history of at least three episodes per year. (Level of Evidence = 1b–)
Synopsis
The researchers enrolled 140 premenopausal women with three or more documented episodes of lower UTI, but not pyelonephritis, in the previous year. In this nonblinded study, the women were randomized, using concealed allocation, to continue their normal levels of water intake or to drink an additional 1.5 liters (three bottles) of Evian-branded water daily for 12 months, which participants on average were able to maintain. Women in the extra water group had approximately one-half as many infections as the usual intake group, with an average of 1.7 documented UTIs over the year compared with an average of 3.2 infections in the usual intake group (P < .001). The extra water resulted in an average of two additional trips to the bathroom each day compared with the usual intake group.
Study design: Randomized controlled trial (nonblinded)
Funding source: Industry
Allocation: Concealed
Setting: Outpatient (any)
Reference: Hooton TM, Vecchio M, Iroz A, et al. Effect of increased daily water intake in premenopausal women with recurrent urinary tract infections: a randomized clinical trial. JAMA Intern Med. 2018;178(11):1509–1515.
Editor's Note: Dr. Ebell is Deputy Editor for Evidence-Based Medicine for AFP and cofounder and Editor-in-Chief of Essential Evidence Plus. Dr. Shaughnessy is an Assistant Medical Editor for AFP.
POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.
For definitions of levels of evidence used in POEMs, see https://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.
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This series is coordinated by Sumi Sexton, MD, Editor-in-Chief.
A collection of POEMs published in AFP is available at https://www.aafp.org/afp/poems.
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