For decades, it has been said that increasing fluid intake could help prevent or cure urinary tract infections. In this issue of JAMA Internal Medicine, a randomized clinical trial confirms that folk wisdom. Hooton and colleagues1 randomized women with 3 or more episodes of cystitis in the prior year to consume 1.5 L of water per day (three 0.5-L bottles) in addition to their usual intake, or to consume no additional water. The women who consumed additional water had an approximately 50% reduction in number of cystitis episodes in the year after randomization and were prescribed fewer antibiotics. We realize that this trial was not blinded, the primary outcome was self-reported, and it was sponsored by Danone Research, which sells the bottled water used in this study. However, the research question is important and the intervention was safe, easy, and effective (and it would be impossible to blind a trial in which drinking water is the intervention). As the authors1 note, the reduction in episodes of cystitis is likely due to increased urine volume and voids that reduce bacterial load in the bladder. Given this, it seems clear that any safe-to-drink water will do, including your local tap water, which will also spare the environmental impact of bottled water and improve the cost-effectiveness of the intervention.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Grady D. Drinking More Water for Prevention of Recurrent Cystitis. JAMA Intern Med. 2018;178(11):1515. doi:10.1001/jamainternmed.2018.4195
Browse and subscribe to JAMA Network podcasts!
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: