Drinking more water reduces bladder infections in women, reducing the need for antibiotics

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Drinking more water each day could be the answer to reducing the risk of bladder infections among premenopausal women, according to US researchers. In a controlled trial, women who drank an additional 1.5 litres of water daily experienced 48% fewer repeat bladder infections than those who drank their usual volume of fluids.

The participants self-reported their usual volume as less than 1.5 litres of fluid daily, which is about six 220ml glasses.

"That's a significant difference," said Dr. Lotan, Chief of Urologic Oncology at UT Southwestern Medical Center. "These findings are important because more than half of all women report having bladder infections, which are one of the most common infections in women."

The researchers noted that more than a quarter of women experienced a secondary infection within six months of an initial infection and 44% to 77% would have a recurrence within a year.

They highlighted that the suspicion was that more fluids helped to reduce bacteria and limit the ability of bacteria to attach to the bladder.

Symptoms for acute uncomplicated cystitis, a type of urinary tract infection (UTI), include painful or difficulty in urination, a feeling of a full bladder, an urgency or frequency of urination, tenderness in the lower abdominal area, and possibly blood in the urine. Because these infections are typically treated with antibiotics, the increased fluid could help reduce use of antibiotics and thereby help control antibiotic resistance, the researchers said.

The findings from their 12-month study, Effect of Increased Daily Water Intake in Premenopausal Women With Recurrent Urinary Tract Infections, which included 140 women with recurrent cystitis, are published in the journal JAMA Internal Medicine

Participants were randomly assigned to drink, in addition to their usual fluid intake, 1.5 litres of water daily – the water group – or no additional fluids – the control group – for 12 months.

Among the highlights over the 12-month study period:

  • 93% of women in the water group had two or fewer episodes of cystitis compared with 88% of women in the control group who had three or more episodes.
  • The number of cystitis episodes was about half in the water group compared with the control group. Overall, there were 327 cystitis episodes – 111 in the water group and 216 in the control group.
  • The estimated mean annual number of antimicrobial regimens used to treat cystitis episodes was 1.9 in the water group compared with 3.6 among the controls.
  • The mean number of antimicrobial regimens used to treat cystitis episodes was 1.8 in the water group, compared with 3.5 in the control group.
  • The mean time interval between cystitis events was 142.9 days in participants in the water group compared with 85.2 days in the control group.
  • The median time to the first cystitis episode was 148 days in the water group compared with 93.5 days in the control group.

The study authors stated: “Increased water intake is an effective antimicrobial-sparing strategy to prevent recurrent cystitis in premenopausal women at high risk for recurrence who drink low volumes of fluid daily.”