Date of this Version


Document Type

Response or Comment

Publication Details

This letter is published in the BRITISH MEDICAL JOURNAL
Guppy MP, Mickan SM, Del Mar CB. Letter : "Drink Plenty of Fluids" : [Authors' reply]. BMJ 2004; 328: 958
BMJ is available online at


"Drink plenty of fluids" - Recommendations are not supported by data - [Authors' reply].

Let us look deeper at the indirect evidence. Two case reports describe children with only infections of the upper respiratory tract with hyponatraemia and seizures. In infections of the lower respiratory tract, observational studies show that increased secretion of antidiuretic hormone occurs in bronchiolitis, where it is the norm. It is becoming standard management to advise careful monitoring and restriction of fluid intake with bronchiolitis.