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Current Drug Safety

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ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

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Research Article

Medications Associated with Occurrence of Urinary Tract Infections in Patients with Diabetes, Heart Failure or Both

Author(s): Joseph Ben Hill, Cy Fixen*, Garth Wright and Joseph J. Saseen

Volume 18, Issue 3, 2023

Published on: 24 June, 2022

Page: [368 - 373] Pages: 6

DOI: 10.2174/1574886317666220414132328

Price: $65

Abstract

Background: Evidence broadly identifying medications newly-initiated prior to the occurrence of a urinary tract infection (UTI) in patients with diabetes, heart failure, or both of these conditions is lacking.

Objective: The aim was to broadly assess medication filling patterns and incidence of UTIs to identify medications or medication classes most frequently initiated prior to UTI occurrence.

Methods: This retrospective study utilizing a national claims database examined medications commonly initiated in the six months preceding a UTI in patients with diabetes and/or heart failure. Patients with a new diagnosis of UTI, a diagnosis of diabetes and/or heart failure, continuous enrollment in the database for at least 12 months prior to the index UTI occurrence, and who initiated at least one new medication in the 6 months preceding the index UTI were evaluated.

Results: 12,744 patients met criteria: 10,626 (83.4%) had a diagnosis of diabetes, 838 (6.6%) had a diagnosis of heart failure, and 1,280 (10.0%) had diagnoses for both. Opioids were the most commonly filled medication class among all three groups. Medications from the SGLT2i class were the twelfth, eleventh, and eighteenth most common medications filled prior to the index UTI for all patients, patients with diabetes, and patients with diabetes and heart failure, respectively.

Conclusion: Opioids were by far the most commonly initiated medication class in the 6 months prior to UTI incidence in patients with diabetes and/or heart failure. SGLT2i medications were not commonly initiated in the 6 months prior to the occurrence of a UTI.

Keywords: Opioids, SGLT2-inhibitors, drug safety, urinary tract infection, diabetes mellitus, heart failure.

« Previous Next »
[1]
Gupta K, Hooton TM, Naber KG, et al. Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis 2011; 52(5): e103-20.
[http://dx.doi.org/10.1093/cid/ciq257] [PMID: 21292654]
[2]
Naber KG, Cho YH, Matsumoto T, Schaeffer AJ. Immunoactive prophylaxis of recurrent urinary tract infections: A meta-analysis. Int J Antimicrob Agents 2009; 33(2): 111-9.
[http://dx.doi.org/10.1016/j.ijantimicag.2008.08.011] [PMID: 18963856]
[3]
Kallen AJ, Welch HG, Sirovich BE. Current antibiotic therapy for isolated urinary tract infections in women. Arch Intern Med 2006; 166(6): 635-9.
[http://dx.doi.org/10.1001/archinte.166.6.635] [PMID: 16567602]
[4]
Geerlings S, Fonseca V, Castro-Diaz D, List J, Parikh S. Genital and urinary tract infections in diabetes: Impact of pharmacologically-induced glucosuria. Diabetes Res Clin Pract 2014; 103(3): 373-81.
[http://dx.doi.org/10.1016/j.diabres.2013.12.052] [PMID: 24529566]
[5]
Hoepelman AI, Meiland R, Geerlings SE. Pathogenesis and management of bacterial urinary tract infections in adult patients with diabetes mellitus. Int J Antimicrob Agents 2003; 22 (Suppl. 2): 35-43.
[http://dx.doi.org/10.1016/S0924-8579(03)00234-6] [PMID: 14527769]
[6]
Hirji I, Guo Z, Andersson SW, Hammar N, Gomez-Caminero A. Incidence of urinary tract infection among patients with type 2 diabetes in the UK General Practice Research Database (GPRD). J Diabetes Complications 2012; 26(6): 513-6.
[http://dx.doi.org/10.1016/j.jdiacomp.2012.06.008] [PMID: 22889712]
[7]
Fernandez JM, Coyle EA. Urinary Tract Infections and Prostatitis.In: Pharmacotherapy. (11th ed.), New York: McGraw-Hill 2020.
[8]
U.S. Food and Drug Administration. FDA drug safety communication: FDA revises labels of SGLT2 inhibitors for diabetes to include warnings about too much acid in the blood and serious urinary tract infections. Safety announcement. 2015. Available from: http://www.fda. gov/Drugs/DrugSafety/ucm475463.htm (Accessed on: 8 January 2021).
[9]
Dave CV, Schneeweiss S, Patorno E. Comparative risk of genital infections associated with SGLT2 inhibitors: A real-world retrospective cohort study. Diabetes Obes Metab 2019; 21: 434-8.
[http://dx.doi.org/10.1111/dom.13531] [PMID: 30207042]
[10]
Puckrin R, Saltiel MP, Reynier P, Azoulay L, Yu OHY, Filion KB. SGLT-2 inhibitors and the risk of infections: A systematic review and meta-analysis of randomized controlled trials. Acta Diabetol 2018; 55(5): 503-14.
[http://dx.doi.org/10.1007/s00592-018-1116-0] [PMID: 29484489]
[11]
Dave CV, Schneeweiss S, Kim D, Fralick M, Tong A, Patorno E. Sodium- glucose cotransporter-2 inhibitors and the risk for severe urinary tract infections: A population-based cohort study. Ann Intern Med 2019; 171(4): 248-56.
[http://dx.doi.org/10.7326/M18-3136] [PMID: 31357213]
[12]
Fisher A, Fralick M, Filion KB, et al. Canadian Network for Observational Drug Effect Studies (CNODES) Investigators. Sodium-glucose co-transporter-2 inhibitors and the risk of urosepsis: A multi-site, prevalent new-user cohort study. Diabetes Obes Metab 2020; 22(9): 1648-58.
[http://dx.doi.org/10.1111/dom.14082] [PMID: 32383792]
[13]
Lega IC, Bronskill SE, Campitelli MA, et al. Sodium glucose cotransporter 2 inhibitors and risk of genital mycotic and urinary tract infection: A population-based study of older women and men with diabetes. Diabetes Obes Metab 2019; 21(11): 2394-404.
[http://dx.doi.org/10.1111/dom.13820] [PMID: 31264755]
[14]
Varshney N, Billups SJ, Saseen JJ, Fixen CW. Sodium-glucose cotransporter-2 inhibitors and risk for genitourinary infections in older adults with type 2 diabetes. Ther Adv Drug Saf 2021; 12: 2042098621997703.
[http://dx.doi.org/10.1177/2042098621997703] [PMID: 33854754]
[15]
van Strien AM, Souverein PC, Keijsers CJPW, Heerdink ER, Derijks HJ, van Marum RJ. Association between urinary tract infections and antipsychotic drug use in older adults. J Clin Psychopharmacol 2018; 38(4): 296-301.
[http://dx.doi.org/10.1097/JCP.0000000000000895] [PMID: 29894393]
[16]
van Strien AM, Souverein PC, Keijsers CK, Heerdink ER, Derijks HJ, van Marum RJ. Antipsychotic drug use associated with urinary tract infections in older women. Maturitas 2017; 98: 46-50.
[http://dx.doi.org/10.1016/j.maturitas.2017.01.009] [PMID: 28274327]
[17]
IQVIA PharMetrics Plus for Academics User Guide & Data Dictionary. IQVIA 2017. Available from: www.iqvia.com
[18]
Khosrow-Khavar F, Kurteva S, Cui Y, Filion KB, Douros A. Opioids and the risk of infection: A critical appraisal of the pharmacologic and clinical evidence. Expert Opin Drug Metab Toxicol 2019; 15(7): 565-75.
[http://dx.doi.org/10.1080/17425255.2019.1634053] [PMID: 31211608]
[19]
Franchi S, Moschetti G, Amodeo G, Sacerdote P. Do all opioid drugs share the same immunomodulatory properties? A review from animal and human studies. Front Immunol 2019; 10: 2914.
[http://dx.doi.org/10.3389/fimmu.2019.02914] [PMID: 31921173]
[20]
Malik AA, Radhakrishnan N, Reddy K, Smith AD, Singhal PC. Morphine-induced macrophage apoptosis modulates migration of macrophages: Use of in vitro model of urinary tract infection. J Endourol 2002; 16(8): 605-10.
[http://dx.doi.org/10.1089/089277902320913314] [PMID: 12470470]
[21]
Breslow JM, Monroy MA, Daly JM, et al. Morphine, but not trauma, sensitizes to systemic Acinetobacter baumannii infection. J Neuroimmune Pharmacol 2011; 6(4): 551-65.
[http://dx.doi.org/10.1007/s11481-011-9303-6] [PMID: 21826405]
[22]
Singhal PC, Kapasi AA, Franki N, Reddy K. Morphine-induced macrophage apoptosis: The role of transforming growth factor-beta. Immunology 2000; 100(1): 57-62.
[http://dx.doi.org/10.1046/j.1365-2567.2000.00007.x] [PMID: 10809959]
[23]
Bhaskaran M, Reddy K, Sharma S, et al. Morphine-induced degradation of the host defense barrier: Role of macrophage injury. J Infect Dis 2001; 184(12): 1524-31.
[http://dx.doi.org/10.1086/324667] [PMID: 11740727]
[24]
Bencsics A, Elenkov IJ, Vizi ES. Effect of morphine on lipopolysaccharide-induced tumor necrosis factor-alpha production in vivo: Involvement of the sympathetic nervous system. J Neuroimmunol 1997; 73(1-2): 1-6.
[http://dx.doi.org/10.1016/S0165-5728(96)00163-4] [PMID: 9058753]
[25]
Roy S, Cain KJ, Chapin RB, Charboneau RG, Barke RA. Morphine modulates NF kappa B activation in macrophages. Biochem Biophys Res Commun 1998; 245(2): 392-6.
[http://dx.doi.org/10.1006/bbrc.1998.8415] [PMID: 9571161]
[26]
Singh PP, Singal P. Morphine-induced neuroimmunomodulation in murine visceral leishmaniasis: The role(s) of cytokines and nitric oxide. J Neuroimmune Pharmacol 2007; 2(4): 338-51.
[http://dx.doi.org/10.1007/s11481-007-9094-y] [PMID: 18040852]
[27]
McMurray JJV, Solomon SD, Inzucchi SE, et al. DAPA-HF Trial Committees and Investigators. Dapagliflozin in patients with heart failure and reduced ejection fraction. N Engl J Med 2019; 381(21): 1995-2008.
[http://dx.doi.org/10.1056/NEJMoa1911303] [PMID: 31535829]
[28]
Anker SD, Butler J, Filippatos G, et al. Effect of empagliflozin on cardiovascular and renal outcomes in patients with heart failure by baseline diabetes status: Results from the emperor-reduced trial. Circulation 2021; 143(4): 337-49.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.120.051824] [PMID: 33175585]

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