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

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.