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.

中文翻译：

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在所有情况下增加液体摄入量以预防成人和儿童的尿路感染：系统评价。

背景技术已经研究了预防尿路感染（UTI）的非抗生素干预措施，作为减少抗生素处方UTI和随后的抗生素耐药性的策略。广泛提倡增加水合作用以预防尿路感染。但是，其有效性的证据尚不清楚。目的：系统地回顾已发表的有关在任何情况下增加液体摄入量作为预防成人和儿童尿路感染的有效性的文献。方法从开始到2019年2月，检索了五个电子数据库，以鉴定已发表的随机对照试验（RCT）和准实验研究，以评估高（≥1.5L / 24 h）与正常/低（<1.5 L / 24 h）的有效性预防泌尿道感染的液体摄入。结果是UTI发生率。使用Cochrane协作工具评估了偏倚风险。由于确定的研究数量很少，因此无法进行荟萃分析。因此，进行了叙事综合。结果在2822篇潜在相关的论文中，有两篇符合纳入条件：RCT（个体随机）和聚类-RCT。两项研究在参与者，设置，样本量，UTI定义和干预方面均存在差异。RCT被评估为具有较低的偏倚风险，而集群RCT则具有较高的偏倚风险。只有RCT（包括健康的绝经前妇女到基层医疗诊所就诊）才显示出高摄入量预防UTI的效果具有统计学意义。