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General medicine
Can drinking more water prevent urinary tract infections? The evidence says yes
  1. Annette Plüddemann
  1. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  1. Correspondence to Dr Annette Plüddemann, Department of Primary Care Health Sciences, University of Oxford, Oxford OX1 2JD, UK; annette.pluddemann{at}

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Although it is widely recommended to drink more water to prevent recurring urinary tract infections (UTIs), there has been no clear clinical evidence to support this recommendation. This is the first randomised controlled trial that shows the benefits of drinking more water to prevent these infections.

EBM verdict

EBM Verdict on: Effect of increased daily water intake in premenopausal women with recurrent urinary tract infections: a randomized clinical trial. JAMA Intern Med 2018; 178(11):1509–1515. doi: 10.1001/jamainternmed.2018.4204.

  • Increasing daily fluid intake to more than 1.5 L per day is a safe and inexpensive intervention that can potentially reduce cystitis frequency and antimicrobial use by approximately 50% and should therefore be recommended in healthy women. Practically, this could be achieved by, for example, drinking an additional two glasses of water with each meal.

To prevent recurrent UTIs, the National Health Service (NHS) recommends to ‘drink plenty of fluids’,1 as it helps to ‘flush out’ the bacteria or does it? There is limited evidence to support this recommendation. Clinical studies done in the 1960s, 1970s and 1980s …

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  • Contributors AP is the sole author.

  • Competing interests AP reports grants from NIHR, grants from NIHR School of Primary Care Research and occasionally receives expenses for teaching Evidence-Based Medicine.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.