Intended for healthcare professionals

Primary Care

“Drink plenty of fluids”: a systematic review of evidence for this recommendation in acute respiratory infections

BMJ 2004; 328 doi: (Published 26 February 2004) Cite this as: BMJ 2004;328:499
  1. Michelle P B Guppy, academic general practice registrar1,
  2. Sharon M Mickan, senior research fellow1,
  3. Chris B Del Mar, professor of general practice (
  1. 1Centre for General Practice, Medical School, University of Queensland, Herston, 4006, Queensland, Australia
  1. Correspondence to: C B Del Mar


    Doctors often recommend drinking extra fluids to patients with respiratory infections. Theoretical benefits for this advice are replacing insensible fluid losses from fever and respiratory tract evaporation, correcting dehydration from reduced intake, and reducing the viscosity of mucus.1 2 To many this advice is self evident and justified on the basis that even if the benefit is uncertain, or at best small, at least it is harmless.

    However, there are theoretical reasons for increased fluid intake to cause harm. Antidiuretic hormone conserves fluid by stimulating water reabsorption from the renal collecting ducts. Increased antidiuretic hormone secretion has been reported in adults and children with lower respiratory tract infections of bronchitis, bronchiolitis, and pneumonia of viral and bacterial aetiology.3 4 …

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