Drinking more water may prevent recurrent cystitis in premenopausal women who drink low volumes of fluid daily, a new study confirmed.

“Increased hydration often is recommended as a preventive measure for women with recurrent cystitis, but supportive data are sparse,” investigators stated.

The study included 140 healthy women (mean age 35.7 years) with recurrent cystitis (3 or more episodes in the past year) who reported drinking less than 1.5 L of fluid daily. Investigators randomly assigned participants to drink 1.5 L of water daily in addition to their usual fluid intake (water group) or no additional fluids (control group) for 12 months. Each group had 70 participants.

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During the 12-month study period, the mean number of cystitis episodes was 1.7 in the water group compared with 3.2 in the control group, Thomas M. Hooton, MD, of the University of Miami School of Medicine, and colleagues reported in JAMA Internal Medicine. The water group experienced 111 cystitis episodes, whereas the control group had 216 episodes.

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In addition, the mean number of antimicrobial regimens used to treat cystitis episodes was 1.9 in the water group compared with 3.6 in the control group. The mean time interval between cystitis episodes was 142.8 days in the water group compared with 84.4 days in the control group. All of the between-group differences were statistically significant.

“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,” Dr Hooton’s team concluded.

The authors pointed out that there are no published data on the proportion of women with recurrent UTI who are low-volume drinkers. “Nevertheless, it 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.”


Hooton TM, Vecchio M, Iroz A, et al. Effect of increased daily water intake in premenopausal women with recurrent urinary tract infection. JAMA Intern Med. 2018; published online ahead of print.