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Antidiabetic medications have gained attention for their potential antimicrobial effects, though data remain limited. This study investigated the inhibitory effects of empagliflozin and metformin against urinary\n                    <jats:italic>E. coli<\/jats:italic>\n                    isolates. Minimum inhibitory concentrations (MICs) were determined via broth microdilution, and synergistic interactions were assessed using the checkerboard method. Biofilm inhibition at sub-inhibitory drug concentrations was evaluated spectrophotometrically, and gene expression of\n                    <jats:italic>fimH<\/jats:italic>\n                    and\n                    <jats:italic>luxS<\/jats:italic>\n                    , were analyzed using RT-qPCR. Empagliflozin and metformin inhibited bacterial growth, with MICs ranging from 3.12\u20136.25\u00a0mg\/mL and 25\u201350\u00a0mg\/mL, respectively. A synergistic effect was observed in two isolates. Both drugs significantly reduced biofilm formation (51.8\u201372.9%) and downregulated\n                    <jats:italic>fimH<\/jats:italic>\n                    and\n                    <jats:italic>luxS<\/jats:italic>\n                    gene expression (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01). This study showed that empagliflozin and metformin could have inhibitory effects against urinary\n                    <jats:italic>E. coli<\/jats:italic>\n                    isolates\n                    <jats:italic>,<\/jats:italic>\n                    supporting their potential in drug repurposing strategies. Empagliflozin and metformin demonstrated significant dose-dependent in vitro antivirulence and antibiofilm activities, further supported by the downregulation of key virulence-associated genes (\n                    <jats:italic>fimH<\/jats:italic>\n                    and\n                    <jats:italic>luxS<\/jats:italic>\n                    ). To the best of our knowledge, this is the first report investigating the in vitro effects of empagliflozin against urinary\n                    <jats:italic>E. coli<\/jats:italic>\n                    isolates, and further investigation is required to determine the impact of antidiabetic medications on\n                    <jats:italic>E. coli.<\/jats:italic>\n                  <\/jats:p>","DOI":"10.1007\/s12223-026-01520-3","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:00:11Z","timestamp":1780470011000},"page":"847-861","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of empagliflozin and metformin on biofilm formation and pathogenicity factors of urinary Escherichia coli isolates"],"prefix":"10.1007","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1549-7219","authenticated-orcid":false,"given":"Aybala","family":"Temel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6891-6662","authenticated-orcid":false,"given":"Ay\u015feg\u00fcl","family":"Ate\u015f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7822-3154","authenticated-orcid":false,"given":"Zinnet \u015eevval","family":"Aksoyalp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"1520_CR1","doi-asserted-by":"publisher","first-page":"808","DOI":"10.4314\/ahs.v17i3.24","volume":"17","author":"HA Abbas","year":"2017","unstructured":"Abbas HA, Elsherbini AM, Shaldam MA (2017) Repurposing metformin as a quorum sensing inhibitor in Pseudomonas aeruginosa. 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