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–)


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.

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

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.



Want to use this article elsewhere? Get Permissions

More in AFP

Editor's Collections

Related Content

More in Pubmed


Oct 2021

Access the latest issue of American Family Physician

Read the Issue

Email Alerts

Don't miss a single issue. Sign up for the free AFP email table of contents.

Sign Up Now

Navigate this Article