[Urinary tract infection caused by Candida while using an SGLT-2 inhibitor]. / Urineweginfectie door Candida bij gebruik SGLT2-remmer.

BACKGROUND: Sodium glucose transporter 2 (SGLT-2) inhibitors are a relatively new group of antidiabetic drugs. The renal glucose reabsorption is blocked resulting in higher glucose levels in the urine (glucosuria). Recently studies are being conducted into the medications nephrological and cardiovascular potential. As a result, we may expect that SGLT-2 inhibitors will be more and more frequently prescribed. Thus, physicians of any specialty may come into contact with patients that are using this drug. CASE DESCRIPTION: We describe a case of a male patient who developed a urinary tract infection with Candida glabrata while using a SGLT-2 inhibitor. After discontinuing the SGLT-2 inhibitor, the infection subsided. CONCLUSION: Urinary tract infections from Candida are rarely seen in healthy individuals. Glucosuria is a known risk factor for fungal genital infections. More research is needed to determine whether SGLT-2 inhibitors increase the risk of fungal urinary tract infections.

The Efficacy of Anti-Arrhythmic Drugs in Children With Idiopathic Frequent Symptomatic or Asymptomatic Premature Ventricular Complexes With or Without Asymptomatic Ventricular Tachycardia: a Retrospective Multi-Center Study.

The aim of the study is to compare the efficacy of flecainide, beta-blockers, sotalol, and verapamil in children with frequent PVCs, with or without asymptomatic VT. Frequent premature ventricular complexes (PVCs) and asymptomatic ventricular tachycardia (VT) in children with structurally normal hearts require anti-arrhythmic drug (AAD) therapy depending on the severity of symptoms or ventricular dysfunction; however, data on efficacy in children are scarce. Both symptomatic and asymptomatic children (≥ 1 year and < 18 years of age) with a PVC burden of 5% or more, with or without asymptomatic runs of VT, who had consecutive Holter recordings, were included in this retrospective multi-center study. The groups of patients receiving AAD therapy were compared to an untreated control group. A medication episode was defined as a timeframe in which the highest dosage at a fixed level of a single drug was used in a patient. A total of 35 children and 46 medication episodes were included, with an overall change in PVC burden on Holter of -4.4 percentage points, compared to -4.2 in the control group of 14 patients. The mean reduction in PVC burden was only significant in patients receiving flecainide (- 13.8 percentage points; N = 10; p = 0.032), compared to the control group and other groups receiving beta-blockers (- 1.7 percentage points; N = 18), sotalol (+ 1.0 percentage points; N = 7), or verapamil (- 3.9 percentage points; N = 11). The efficacy of anti-arrhythmic drug therapy on frequent PVCs or asymptomatic VTs in children is very limited. Only flecainide appears to be effective in lowering the PVC burden.