Trending Clinical Topic: UTI

Ryan Syrek

Disclosures

August 09, 2019

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News about drug approvals and treatment strategies, along with new guidelines, helped make urinary tract infection (UTI) this week's top trending clinical topic. A study of sodium-glucose cotransporter-2 (SGLT-2) inhibitors used to treat type 2 diabetes mellitus found that the drugs do not appear to increase the risk for UTIs, compared with two other classes of type 2 diabetes agents. Although SGLT-2 inhibitors have demonstrated a clear link to increased risk for genital infections, this new study of more than 100,000 patients found that the drugs did not increase rates of serious or nonserious UTIs compared with either dipeptidyl peptidase-4 (DPP-4) inhibitors or glucagon-like peptide-1 receptor (GLP-1) agonists. Although this news is reassuring, the study did exclude patients already at high risk for UTIs (eg, those with hydronephrosis, vesicoureteral reflux, spinal cord injuries, catheter use).

In other encouraging news, the US Food and Drug Administration (FDA) approved the antibacterial drug trio imipenem, cilastatin, and relebactam for use in certain patients with complicated UTI (cUTI) and complicated intra-abdominal infection (cIAI). The combination represents a new tool for adults with cUTI and cIAI with limited or no other treatment options. Prompt treatment is key in certain populations with UTI, according to another recent study. Patients older than 65 years who have UTI are at increased risk for sepsis and death within 60 days if not immediately treated with antibiotics, according to research published in BMJ. The findings suggest that early prescription of antibiotics should be considered in these patients, particularly those older than 85 years.

Finally, the first-ever guidelines for uncomplicated, recurrent UTI were released by the American Urological Association (AUA). The guidelines emphasize the importance of cultures and antibiotic stewardship. Other aspects include a conditional recommendation for the use of cranberry as prophylaxis and a moderate recommendation for the use of vaginal estrogen. From drug-related news to detailed guidance, important treatment information helped take UTI to the top of this week's trending clinical topics.

Test your knowledge of UTIs with this quick quiz.

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