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Drinking more water cuts UTI risk in half, sparing antibiotics
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SAN DIEGO — Drinking around one more liter of water per day cuts the risk for urinary tract infections in half for women who are prone to getting them, according to researchers.
In a news conference at IDWeek, Thomas M. Hooton, MD, clinical director of the division of infectious diseases at the University of Miami School of Medicine, summarized results from a study examining the effect of increased water intake in women who frequently contract acute uncomplicated UTIs. In addition to preventing the infections, the study showed that women who drank more water were prescribed fewer antibiotics, an important step in reducing antimicrobial resistance.
“What we’re talking about is prevention of urinary tract infections, not treatment,” Hooton said. “What we would like to do in infectious diseases is try to reduce the need for antibiotics because antibiotic use leads to antibiotic resistance. So, anything that we can come up with that reduces antibiotic use is a good thing, as long as it’s safe and it works.”
According to experts, UTIs affect up to 60% of women in their lifetime, leading to more than 10 million doctor visits per year.
For their study, Hooton and colleagues enrolled 140 healthy premenopausal women at a Bulgarian research center who had at least three UTIs in the past year and self-reported drinking less than 1.5 liters of water per day. They randomly assigned half of the women to drink an additional 1.5 liters of water per day for 12 months and the other half to continue with their regular daily fluid intake. They documented the results in monthly telephone calls and at clinical visits after 6 and 12 months.
Over the course of the study, women in the intervention group on average increased their daily water intake by 1.15 liters, or about 2.5 pints, for a daily fluid intake that included water and other beverages of 2.8 liters, according to Hooton and colleagues. Women in the control group drank 1.2 liters of fluid daily with no change to their daily fluid intake.
In 12 months, women who increased their water intake had, on average, 1.6 UTIs compared with an average of 3.1 UTIs in the control group, Hooton and colleagues reported. Moreover, women in the water group averaged 1.8 regimens of antibiotics compared with 3.5 in the control group.
According to Hooton, drinking more fluids increases the rate at which bacteria are flushed from the bladder and likely reduces the concentration of bacteria that enter the bladder from the vagina, reducing infections.
According to Hooton, increased intake of any type of fluids is likely to have the same benefit as drinking more water. He said physicians have long recommended that patients with UTIs drink more fluids, but that the validity of the recommendation has not been adequately studied.
“It always helps to have confirmatory data,” Hooton said. “We say a lot of things to our patients, but it helps to be able to say that a well-done study looked at this question very carefully and showed the risk was pretty dramatically reduced. It may not do away with all your infections, but if we can reduce antibiotics in you and other people, we think that’s a major benefit.” – by Gerard Gallagher
Reference:
Hooton TM, et al. Abstract LB-7. Presented at: IDWeek; Oct. 4-8, 2017; San Diego.
Disclosures: Please see the study for all authors’ relevant financial disclosures.
Perspective
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Susan C. Bleasdale, MD
UTIs affect most women. There are estimates from a 2010 review that somewhere between 11 million and 12 million women a year will suffer from a UTI. Annually, that might account for $1.6 billion worth of prescriptions. That is a large number of antibiotics, which is why we have seen an increase in resistance in UTIs. Traditionally, to try to decrease resistance for antibiotic stewardship, we try to make the right diagnoses, try not to use antibiotics for things like viruses, and when we know we have an infection, we choose to use the right drug and right duration. This study might be a game-changer for stewardship in that we might not even need to use antibiotics.
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