Written By: N. Lothungbeni Humtsoe | Published : June 9, 2026 2:00 PM IST
UTI. (Image: AI Generated)
Urinary tract infections (UTIs) are among the most common bacterial infections worldwide caused by Escherichia coli (E. coli) a bacterium that poses one of the greatest challenges in treating UTIs. Researchers claim that this bacterium can form protective layers called biofilms which enable microbes to survive, multiply and withstand antibiotic therapy. A study published on 3 June in Springerfound that two drugs commonly used to treat diabetes i.e. empagliflozin and metformin could fight urinary E. coli by inhibiting its ability to form biofilms and reducing its virulence.
The results are especially noteworthy in an era of increasing antimicrobial resistance which poses a significant threat to global health. With the number of antibiotics becoming more common to treat infections and multidrug-resistant bacteria researchers are turning to drug repurposing as a faster and more efficient strategy for existing drugs.
The researchers tested the ability of empagliflozin and metformin which are both commonly used in the treatment of type 2 diabetes to inhibit E. coli isolates under laboratory conditions. Scientists mentioned that the antibacterial activity of both drugs was evaluated by a broth microdilution method to find the minimum inhibitory concentration (MIC) of each. They also compared the two drugs together to measure if they could work together to give a better effect in the checkerboard analysis. Additionally the study examined biofilm inhibition at subinhibitory concentrations and measure virulence-associated-genes were quantified by reverse transcription quantitative polymerase chain reaction (RT-qPCR).
The result showed that both drugs were found to have inhibitory activity against the urinary E. coli isolates. Empagliflozin has been reported to have MIC values of 3.12 to 6.25 mg/mL and metformin was reported to have MIC values of 25 to 50 mg/mL. Interestingly a synergistic interaction between both drugs was noted in two bacterial isolates indicating that the combined use of the two drugs might be more effective against bacteria in some instances.
The team of scientists mentioned that the most significant was on biofilm formation. They noted that recurrent and persistent UTIs are partially due to biofilms which enable bacteria to stick to surfaces and resist the body's defences and antibiotics.
The study found that empagliflozin and metformin decreased biofilm production by 51.8 to 72.9 per cent. This significant decrease indicates the possible anti-biofilm properties of both medications at concentrations lower than the ones needed to inhibit bacterial growth completely.
Urinary Tract Infection (UTI) - Treatment#medtwitter#foamed#mededpic.twitter.com/i7GgQxiyoR
Manual Of Medicine (@ManualOMedicine) December 15, 2025
In further analysis scientists also found that both drugs significantly downregulate the expression of two virulence associated genes which are fimH and luxS (p<0.01). These genes are known to be associated with bacterial adhesion, communication and biofilm development. The drugs will inhibit the activity and reduce the ability of urinary E. coli to establish infection and stay in the urinary tract.
The researchers noted that these results indicate the possibility of using drugs used for diabetes in the future as repurposing drugs for urinary E. coli. Additionally the study is the first to investigate the in vitro effect of empagliflozin on the urinary E. coli strains.
The results showed dose-dependent antibacterial, antibiofilm and antivirulence activity but the authors stressed that before use in clinical practice these drugs require further studies. The research is a positive sign for the possibility that some already available drugs could be useful in combating the increasing problem of antibiotic-resistant infections.
Disclaimer: This article is for informational purposes only and does not replace medical advice. Always consult a healthcare professional before starting, stopping or changing any medication.
