{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T16:15:25Z","timestamp":1791130525464,"version":"4.1.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The increasing prevalence of extended-spectrum \u03b2-lactamase (ESBL)\u2013producing bacteria has limited treatment options for cystitis. The recommendation of nitrofurantoin for treatment is based solely on in vitro studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We aimed to evaluate the effectiveness of nitrofurantoin versus comparators in treating cystitis due to ESBL-producing Enterobacterales in the clinical setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This was a multicenter retrospective cohort study of afebrile adults with symptomatic cystitis and a urine culture of \u226510\n                      <jats:sup>5<\/jats:sup>\n                      CFU\/mL of ESBL-producing organism susceptible to nitrofurantoin and comparator antibiotics. Patients were categorized based on treatment (nitrofurantoin vs comparator). Clinical cure was the primary endpoint. Reinfection and relapse were secondary endpoints.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 225 patients, 66 received nitrofurantoin and 159 received a comparator. Carbapenems were the most used comparator (57.2%). Clinical cure rates were not significantly different between the groups in crude (77.3% vs 86.2%;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.101) and regression analyses (adjusted odds ratio [aOR], 0.82; 95% CI, 0.34-1.99). Of 35.4% of nitrofurantoin patients and 66.0% comparators group patients who had follow-up cultures, lower odds of relapse and reinfection were observed with nitrofurantoin, though not statistically significant (aOR, 0.28; 95% CI, 0.07-1.18 and aOR, 0.43 with 95% CI of 0.13-1.43, respectively). However, the inpatient setting was significantly associated with higher odds of relapse (aOR, 8.83; 95% CI, 1.07-72.74;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.043).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and relevance:<\/jats:title>\n                    <jats:p>Nitrofurantoin was as effective as comparators in treating cystitis due to ESBL-producing Enterobacterales. The inpatient setting was associated with higher odds of relapse. Further larger research trials are needed to validate these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10600280251315950","type":"journal-article","created":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T01:08:36Z","timestamp":1740186516000},"page":"785-793","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Nitrofurantoin Versus Comparators in the Treatment of Cystitis due to Extended-Spectrum \u03b2-Lactamase\u2013Producing Enterobacterales: A Multicenter Cohort Study"],"prefix":"10.1177","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0369-9094","authenticated-orcid":false,"given":"Abrar K.","family":"Thabit","sequence":"first","affiliation":[{"name":"Pharmacy Practice Department, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi 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