Recurrent Acute Uncomplicated Cystitis in Women: Examining the Efficacy of Preventive Hydration

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At 12 months, the water group experienced statistically significant increases in mean daily water intake, total fluid intake, urine volume, and number of urine voids.
At 12 months, the water group experienced statistically significant increases in mean daily water intake, total fluid intake, urine volume, and number of urine voids.
This article is part of Infectious Disease Advisor's coverage of IDWeek 2017™, taking place in San Diego, CA. Our on-site staff will be reporting on the latest breaking research and clinical advances in infectious diseases. Check back regularly for highlights from IDWeek 2017.

SAN DIEGO — Increased hydration of at least 1.5 L of water daily in addition to normal fluid intake reduced recurrent acute uncomplicated cystitis episodes in premenopausal women, according to a study presented at IDWeek 2017.

Researchers recruited 140 healthy premenopausal women with recurrent acute uncomplicated cystitis (≥3 episodes within the past 1 year) who were drinking <1.5 L of fluids per day. Participants were randomly assigned to receive either 1.5 L of water in addition to baseline fluids or no additional fluids for 1 year.

Compared with the control group, participants in the water group increased both their daily water intake significantly (1.15 L vs -0.01 L) and their total fluid intake (1.65 L vs 0.03 L) from baseline. Furthermore, urine volume (1.40 L vs 0.04 L), number of urine voids (2.2 vs -0.2), and urine osmolality (-408 vs 035 mOsm/kg) was significantly changed in the water group relative to the control group.

Participants in the water group had significantly fewer recurrent acute uncomplicated cystitis episodes on average compared with those in the control group (1.6 vs 3.1; odds ratio [OR] 0.52; 95% CI, 0.46-0.60; P <.001). The researchers noted that the water regimen was antimicrobial-sparing, as the mean number of antimicrobial regimens to treat cystitis events was decreased in the water group (3.5 vs 1.8; P <.001).

Increased hydration also extended the mean number of days to the first recurrent acute uncomplicated cystitis event (148 vs 93; P =.0005) as well as the mean number of days between episodes (143 vs 85; P <.0001).

The study authors concluded that the results “provide strong evidence that increased water intake is an effective antimicrobial-sparing preventive strategy for women with [recurrent acute uncomplicated cystitis].”

Disclosures

With the exception of Thomas M. Hooton, MD, and Yair Lotan, MD, the remaining authors have either received a consulting fee or are employed by Danone Research. A full listing of disclosures can be viewed here.

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Reference

Hooton TM, Vecchio M, Iroz A, et al. Prevention of recurrent acute uncomplicated cystitis by increasing daily water in premenopausal women: a prospective randomized controlled study. Presented at: IDWeek 2017; October 4-8, 2017; San Diego, CA. Oral Abstract LB-7.

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