{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T06:04:09Z","timestamp":1783490649215,"version":"3.55.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2019,8,29]],"date-time":"2019-08-29T00:00:00Z","timestamp":1567036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Netherlands Organization for Scientific Research"},{"name":"ZonMW-Vidi","award":["917.16.430"],"award-info":[{"award-number":["917.16.430"]}]},{"name":"Leiden University Medical Center fellowship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>It is unknown whether nitrofurantoin 50\u2009mg normal-release every 6\u2009h (NF50) and nitrofurantoin 100\u2009mg extended-release every 12\u2009h (NF100) are equally effective for treating cystitis in primary care. In the Netherlands, GP prescription of either option largely depends on pharmacy procurement, rather than on patient-related factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>GP data between January 2013 and July 2018 were retrospectively collected. Inclusion criteria were the use of nitrofurantoin for uncomplicated cystitis, complicated cystitis or cystitis in pregnancy. Criteria for early and late failure were a second antibiotic prescription for cystitis or pyelonephritis within 14 and 28\u2009days post-prescription, respectively. Crude and confounder-adjusted (CA) risk differences (RDs) were estimated using linear regression. Instrumental variable analysis and CA instrumental variable analysis used GP practice proportion of NF50 versus NF100 use as the instrumental variable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For uncomplicated cystitis (n=46855), treatment with NF50 and NF100 resulted in late failure in 9.7% and 9.6%, respectively. The CA RD, instrumental variable RD and CA instrumental variable RD were 0.2% (95% CI=\u22120.5 to 0.8), \u22120.7% (95% CI=\u22121.7 to 0.3) and 0.0% (95% CI=\u22120.9 to 1.0), respectively. In complicated cystitis (n=10767), late failure occurred in 10.9% and 11.1% after using NF50 and NF100, respectively [CA RD=0.5% (95% CI=\u22121.2 to 1.8), instrumental variable RD=\u22120.8% (95% CI=\u22123.4 to 1.8) and CA instrumental variable RD=\u22120.3% (95% CI=\u22123.0 to 2.4)]. For cystitis in pregnancy (n=1087), NF50 and NF100 resulted in late failure in 13.4% and 7.8%, respectively [CA RD=\u22125.4% (95% CI=\u221210.0 to \u22121.4), instrumental variable RD=\u22128.9% (95% CI=\u221216.0 to \u22121.8) and CA instrumental variable RD=\u22128.9% (95% CI=\u221216.0 to \u22121.7)]. No differences were observed in early failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with cystitis in pregnancy, NF100 was associated with a lower incidence of late clinical failure compared with NF50. We found no differences in clinical failure between NF50 and NF100 for uncomplicated and complicated cystitis.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jac\/dkz350","type":"journal-article","created":{"date-parts":[[2019,8,9]],"date-time":"2019-08-09T11:19:17Z","timestamp":1565349557000},"page":"3337-3343","source":"Crossref","is-referenced-by-count":7,"title":["Effectiveness of extended- versus normal-release nitrofurantoin for cystitis: an instrumental variable analysis"],"prefix":"10.1093","volume":"74","author":[{"given":"Thijs","family":"ten Doesschate","sequence":"first","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Heidelberglaan 100, CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf H H","family":"Groenwold","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc J M","family":"Bonten","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Heidelberglaan 100, CX Utrecht, The Netherlands"},{"name":"Department of Medical Microbiology, University Medical Center Utrecht, University of Utrecht, Heidelberglaan 100, CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelis H","family":"van Werkhoven","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Heidelberglaan 100, CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,29]]},"reference":[{"key":"2019101809594081100_dkz350-B1","first-page":"97","article-title":"NHG-Standaard \u2018Urineweginfecties\u2019","volume":"47","author":"Damen","year":"2013","journal-title":"Geneesmiddelenbulletin"},{"key":"2019101809594081100_dkz350-B2","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1093\/cid\/ciq257","article-title":"International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases","volume":"52","author":"Gupta","year":"2011","journal-title":"Clin Infect Dis"},{"key":"2019101809594081100_dkz350-B3","doi-asserted-by":"crossref","first-page":"2916","DOI":"10.1093\/jac\/dky255","article-title":"Review of the pharmacokinetic properties of 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