Nitrofurantoin Versus Comparators in the Treatment of Cystitis due to Extended-Spectrum β-Lactamase–Producing Enterobacterales: A Multicenter Cohort Study.

This article focuses on evaluating the clinical effectiveness of nitrofurantoin compared to other antibiotics in treating cystitis caused by extended-spectrum β-lactamase (ESBL)–producing Enterobacterales. In a multicenter retrospective cohort study of 225 adults in Saudi Arabia, nitrofurantoin demonstrated similar clinical cure rates to comparator antibiotics, primarily carbapenems, despite a higher observed relapse rate that was not statistically significant after adjustment. The inpatient setting was independently associated with increased odds of relapse. The findings support nitrofurantoin as a viable treatment option for ESBL-related cystitis, though further large-scale prospective studies are recommended to confirm these results.