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Updated: Jan 31, 2026
Transurethral Induction of Mouse Urinary Tract Infection
Published on: August 5, 2010
Urinary Tract Infections and Fungal Infections Associated with Sodium-Glucose Co-transporter-2 (SGLT-2) Inhibitors
Zinnet Şevval Aksoyalp1, Aybala Temel2
1Department of Pharmacology, Izmir Katip Celebi University Faculty of Pharmacy, Izmir, Türkiye.
Objective:
This study aimed to compare the rates of urinary tract infections (UTIs) and fungal infections associated with metformin, sodium-glucose co-transporter-2 (SGLT-2) inhibitors, and their combination.
Materials And Methods:
We collected data on UTIs and fungal infections related to metformin, SGLT-2 inhibitors, and their combinations from the FDA Adverse Event Reporting System (FAERS) database. We calculated the reporting odds ratio (ROR) and 95% confidence intervals (CI) to assess the risk associated with these adverse events when using these medications. We evaluated differences in categorical variables using the Chi-squared test.
Results:
SGLT-2 inhibitors present a higher risk of UTIs and fungal infections compared to metformin. Empagliflozin showed the lowest risk of UTIs (ROR 0.928, 95% CI 0.858-1.005), while dapagliflozin exhibited the lowest risk of fungal infections (ROR 0.874, 95% CI 0.815-0.938). Additionally, patients using SGLT-2 inhibitors alone reported more cases of UTIs and fungal infections than those treated with a combination of SGLT-2 inhibitors and metformin (ROR>1).
Conclusion:
SGLT-2 inhibitors are associated with an increased risk of UTIs and fungal infections compared to combination therapy with an SGLT-2 inhibitor and metformin. The reduced infection reports with combined SGLT-2 inhibitors and metformin therapy may be due to the potential antimicrobial activity of metformin.
Insights
Sodium-glucose co-transporter-2 (SGLT-2) inhibitors increase the risk of urinary tract infections (UTIs) and fungal infections compared to metformin. Combination therapy with metformin may reduce these infection risks.
Area of Science:
- Endocrinology
- Pharmacovigilance
- Infectious Disease
Background:
- Metformin and sodium-glucose co-transporter-2 (SGLT-2) inhibitors are common antidiabetic medications.
- Both drug classes have been associated with genitourinary infections, but comparative risks are not fully elucidated.
Purpose of the Study:
- To compare the incidence of urinary tract infections (UTIs) and fungal infections between metformin, SGLT-2 inhibitors, and their combination therapy.
- To identify specific SGLT-2 inhibitors with potentially lower or higher risks of these infections.
Main Methods:
- Utilized data from the FDA Adverse Event Reporting System (FAERS) database.
- Calculated reporting odds ratios (ROR) and 95% confidence intervals (CI) to assess adverse event risks.
- Employed Chi-squared tests for categorical variable comparisons.
Main Results:
- SGLT-2 inhibitors demonstrated a higher risk of UTIs and fungal infections than metformin.
- Empagliflozin had the lowest UTI risk (ROR 0.928), and dapagliflozin had the lowest fungal infection risk (ROR 0.874).
- Monotherapy with SGLT-2 inhibitors showed higher infection rates than combination therapy with metformin.
Conclusions:
- SGLT-2 inhibitors are linked to increased UTI and fungal infection risks compared to metformin.
- Combination therapy with SGLT-2 inhibitors and metformin may lower infection rates, potentially due to metformin's antimicrobial properties.
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