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Research presented at the 2017 annual meeting of the Infectious Diseases Society of America indicates that women at risk of urinary tract infection (UTI) who increased their water intake by drinking an additional three pints of water a day were almost half as likely to get infections as women who did not.
It is estimated that at least 40-60% of women develop a urinary tract infection (UTI) during their lifetime, with one in in four women likely to experience a repeat infection.1 Women’s health clinicians are all too familiar with UTIs. In one year, of the estimated 11 million office and outpatient hospital UTI visits by patients 20 years of age and older, about 9 million visits were logged by women.2
Research presented at the 2017 annual meeting of the Infectious Diseases Society of America indicates that women at risk of UTIs who increased their water intake by drinking an additional three pints of water a day were almost half as likely to get infections as women who did not.3 General daily recommendations for intake of total water — from all beverages and foods — is 2.7 liters (91 ounces) for women and about 3.7 liters (125 ounces) for men.4
“While doctors have long assumed this is the case and often recommended that women at risk for UTIs increase their fluid intake, it’s never really undergone a prospective trial before,” notes Thomas Hooton, MD, lead author of the study and clinical director of the division of infectious diseases at the University of Miami School of Medicine. “It’s good to know the recommendation is valid, and that drinking water is an easy and safe way to prevent an uncomfortable and annoying infection.”
To conduct the study, researchers followed 140 healthy premenopausal women who had at least three UTIs in the past year and reported low daily fluid intake. Women in the control group continued their usual daily fluid intake; those not in the control group were advised to drink 1.5 liters (about three 16-ounce glasses) of water a day in addition to their usual daily fluid intake. Data indicate that after one year, women in the control group had 3.1 UTIs on average, while those in the group drinking additional water had 1.6 UTIs on average. Women in the water group averaged fewer regimens of antibiotics (1.8) than the limited-water group (3.5).3
Urinary tract infections are bacterial in nature and may involve the lower or upper urinary tract or both. Cystitis is diagnosed when infection is limited to the lower urinary tract and presents with dysuria, frequent and urgent urination, and suprapubic tenderness in some instances. Acute pyelonephritis is diagnosed when there is infection of the renal parenchyma and pelvicaliceal system, accompanied by significant bacteriuria with fever and flank pain.5
A three-day antimicrobial regimen is now the recommended treatment for uncomplicated acute bacterial cystitis.5 Trimethoprim-sulfamethoxazole for three days is considered the preferred therapy, offering a 94% bacterial eradication rate. In areas where antimicrobial resistance to trimethoprim-sulfamethoxazole exceeds 15-20%, clinicians may look at using trimethoprim alone, ciprofloxacin, levofloxacin, norfloxacin, or gatifloxacin.5
Antimicrobial resistance is a valid concern for healthcare providers. Data from areas reporting antimicrobial susceptibility profiles reflect the prevalence of resistance to amoxicillin and trimethoprim-sulfamethoxazole as high as 30% in some populations.5
Results of a recent meta-analysis and assessment of human clinical trials suggest that cranberry products may be used as a first step in reducing recurrent UTIs.6 Such products are a low-cost, low-risk, and effective way to help prevent recurrent UTIs, researchers state. The analysis included 28 studies, with results from nearly 5,000 patients. Researchers found a statistically significant risk reduction in repeat UTIs overall, but not significant for any particular subgroup. Patients with recurrent UTIs who ingested cranberry products and had undergone gynecological surgery experienced a significant reduction in UTIs, the analysis suggests.6
The proanthocyanidins in cranberry fruit are bioactive components assoc-iated with prevention of urinary tract infections.7 Their ability to inhibit bacteria from sticking to the urinary tract walls may lead to their effectiveness in limiting infection growth and recurrence, scientists believe.
“Our investigation supports that cranberry products can be a powerful tool to fight off frequent UTIs,” says lead author, Ângelo Luís, PhD, a researcher at the University of Beira Interior in Covilhã, Portugal. “While recommendations for dosage and duration of treatment require further study, the efficacy of the medicinal properties of cranberry products has been well-established.”
Financial Disclosure: Consulting Editor Robert A. Hatcher, MD, MPH, Nurse Planner Melanie Deal, MS, WHNP-BC, FNP-BC, Author Rebecca Bowers, Executive Editor Shelly Morrow Mark, Copy Editor Savannah Zeches, and Editorial Group Manager Terrey L. Hatcher report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.