Impact of recently initiated medications on the incidence of urinary tract infections in patients with type 2 diabetes: an observational case-control study.

Background: Patients with type 2 diabetes (T2DM) are at risk of developing urinary tract infections (UTIs). Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a common medication associated with UTIs in these patients. However, emerging data show that other medications may be more frequently prescribed prior to UTI diagnosis. Objectives: Explore the correlation of newly prescribed medications in patients with the diagnosis of T2DM prior to an incidence of UTI and compare it to those without a UTI. Design: This observational case-control study aimed to explore the correlation between the incidence of UTIs in patients with T2DM and new prescription medication fills. Methods: Data were retrieved from national prescription and medical claims database IQVIA PharMetric® Plus for Academics between 2018 to 2021. The exposed cohort included patients with T2DM and an encounter for UTI. The comparator cohort was developed using propensity score matching and consisted of patients with T2DM and a health care encounter, but without a diagnosis of UTI. Results: A total of 31,746 patients met study criteria, with 15,873 in both the exposed and matched comparator cohorts. The medications with the largest percentage point difference were opioids at 3.70 (p-value <0.001), statins at 3.42 (p-value <0.001), amoxicillin at 2.48 (p-value <0.001), metformin at 2.45 (p-value <0.001), and PPIs at 2.19 (p-value <0.001). SGLT2i were the 19th most prescribed medication class. Conclusion: Opioids, statins, amoxicillin, metformin, and PPIs were the top 5 medications prescribed prior to the UTI event based on percentage point difference. SGLT2i were not in the top 10 medications initiated prior to UTI. This adds to existing literature that other new start medications may be correlated with a higher risk of developing a UTI such as opioids and PPIs than SGLT2 inhibitors in patients with T2DM.