{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:10:23Z","timestamp":1786122623694,"version":"build-2736575974"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004721","name":"The University of Tokyo","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004721","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Microbiol Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Oral cephalosporins are frequently prescribed for uncomplicated cystitis. Although cephalexin and cefaclor (first- and second-generation oral cephalosporins) exhibit favorable pharmacokinetic properties, third-generation agents demonstrate lower and more variable bioavailability, potentially resulting in reduced clinical effectiveness. This study compared oral third-generation cephalosporins with cephalexin and cefaclor in treating uncomplicated cystitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using a nationwide claims database in Japan (2006\u20132022). We included adult women aged\u2009\u2265\u200918 years who newly received oral third-generation (cefdinir, cefpodoxime proxetil, cefditoren pivoxil, or cefcapene pivoxil) or first-\/second-generation cephalosporins (cephalexin or cefaclor) for acute uncomplicated cystitis, with a prescription duration of 5\u20137 days. The primary outcome was a composite of pyelonephritis diagnosis or additional antibiotic use within 7 days. Secondary outcomes included the individual primary outcome components, all-cause hospitalization, and adverse events. We conducted propensity-score overlap weighting to adjust for possible confounders and stratified analyses by age (&lt;\u200950 or \u2265\u200950 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 40,003 eligible patients, 90.7% received third-generation cephalosporins. The proportion of the primary outcome was significantly higher in the third-generation group than in the first-\/second-generation group (8.4% vs. 6.5%; risk difference, 1.9%; 95% confidence interval, 1.0%\u20132.7%). Among the secondary outcomes, additional antibiotic treatment was more frequent in the third-generation group, whereas the proportions of pyelonephritis diagnosis and other outcomes were similar between the groups. Subgroup analyses showed consistent results across age strata.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Oral third-generation cephalosporins may be associated with more frequent additional antibiotic treatment compared with cephalexin or cefaclor in the management of uncomplicated cystitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10096-026-05622-1","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T11:39:40Z","timestamp":1786102780000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of oral third- versus first-\/ second-generation cephalosporins for acute uncomplicated cystitis: a nationwide retrospective cohort study"],"prefix":"10.1007","author":[{"given":"Jumpei","family":"Taniguchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shotaro","family":"Aso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"5622_CR1","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.1056\/NEJMcp1104429","volume":"366","author":"TM Hooton","year":"2012","unstructured":"Hooton TM (2012) Clinical Practice. 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