Vol.64 No.5 September 2016
Urinary tract infections in the patients with SGLT2 inhibitor
Department of Infectious Diseases and Infection Control, Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, Japan
Abstract
Diabetes mellitus has been considered as one of the risk factors for urinary tract infection, because of increased bacterial adhesion, neutrophil dysfunction, neurogenic bladder and glycosuria. Since SGLT (sodium dependent glucose co-transporter) 2 inhibitors reduce reabsorption of renal glucose in the proximal tubule, excretion of urinary glucose will be increased. Therefore, it was understandable that a meta-analysis indicated the higher prevalence of urinary tract infections in patients with SGLT2 inhibitors compared with the control group. However, glycosuria was not demonstrated as one of the risk factors for urinary tract infection in vivo, whereas it enhanced the bacterial growth in vitro. In addition, the definition, classification or additional risk factors of urinary tract infections were not described in many studies that evaluated the efficacy of SGLT2 inhibitors. Therefore, further studies are needed to clarify the relationship between SGLT2 inhibitors and the prevalence of urinary tract infections in patients with diabetes mellitus. On the other hand, the prevalence of asymptomatic bacteriuria, cystitis and acute pyelonephritis in patients with diabetes mellitus was higher than that in patients without diabetes mellitus. Furthermore, diabetes mellitus was associated with severe urinary tract infection, such as emphysematous pyelonephritis. Thus, we should be aware of urinary tract infection in diabetic patients with or without SGLT2 inhibitors.
Key word
diabetes mellitus, SGLT2 inhibitor, urinary tract infection, glycosuria
Received
January 6, 2016
Accepted
May 11, 2016
Jpn. J. Chemother. 64 (5): 719-725, 2016
