Genitourinary Tract Infections in Patients Taking SGLT2 Inhibitors: JACC Review Topic of the Week.

Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have been shown to reduce adverse cardiovascular events in patients with type 2 diabetes mellitus, all-cause mortality, and heart failure hospitalization in patients with heart failure, as well as adverse renal outcomes. However, concerns regarding the heightened risk of genitourinary (GU) infections, particularly urinary tract infections, remain a significant barrier to their wider adoption. Addressing these misconceptions using existing evidence is needed to ensure proper risk-benefit assessment and optimal utilization of this efficacious therapy. This review aims to provide a balanced perspective on the evidence-based cardiovascular and renal benefits of SGLT2is and the associated risk of GU infections. We also summarize and propose clinical practice considerations for SGLT2i-associated GU infections focusing on patients with cardiovascular disease. [Display omitted] • Treatment with SGLT2is is associated with an increased risk of GMI but not UTI or necrotizing fasciitis of the perineum (Fournier's gangrene). • The benefits of SGLT2is usually outweigh the risk of treatment-associated GU infections. • In most cases, patients developing mild-moderate or stable severe GU infections can continue SGLT2is. [ABSTRACT FROM AUTHOR]