Increased fluid intake for the prevention of urinary tract infection in adults and children in all settings: a systematic review

O. Fasugba, B. G. Mitchell, E. McInnes, J. Koerner, A. C. Cheng, H. Cheng, S. Middleton

Research output: Contribution to journalReview ArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Background: Non-antibiotic interventions for urinary tract infection (UTI) prevention have been investigated as a strategy to reduce antibiotic prescribing for UTI and subsequent antibiotic resistance. Increased hydration is widely advocated for preventing UTI; however, evidence for its effectiveness is unknown. Aim: To systematically review the published literature on the effectiveness of increased fluid intake as a preventive intervention for UTI in adults and children in any setting. Methods: Five electronic databases were searched from inception to February 2019 to identify published randomized controlled trials (RCTs) and quasi-experimental studies evaluating the effectiveness of high (≥1.5 L/24 h) versus normal/low (<1.5 L/24 h) fluid intake for UTI prevention. The outcome was UTI incidence. Risk of bias was assessed using the Cochrane Collaboration's tool. Due to the small number of studies identified, meta-analysis was not possible. Hence a narrative synthesis was undertaken. Findings: Of the 2822 potentially relevant papers, two were eligible for inclusion: an RCT (individual randomization) and a cluster-RCT. Both studies differed regarding participants, setting, sample size, UTI definition, and intervention. The RCT was assessed as having a low risk of bias whereas the cluster-RCT had a high risk of bias. Only the RCT, which included healthy premenopausal women visiting primary care clinics, demonstrated statistical significance for the effect of high fluid intake for UTI prevention. Conclusion: The lack of enough adequately powered and robust RCTs highlights the need for further research on the effectiveness of this intervention for UTI prevention.

Original languageEnglish
Pages (from-to)68-77
Number of pages10
JournalJournal of Hospital Infection
Volume104
Issue number1
DOIs
Publication statusPublished - Jan 2020

Keywords

  • Behaviour change
  • Fluid intake
  • Hydration
  • Systematic review
  • Urinary tract infection

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