This clinical trial is focused on finding effective treatments for urinary tract infections (UTIs) and bacteremia caused by bacteria known as extended spectrum beta-lactamases (ESBL)-producing Enterobacterales. These bacteria are resistant to many common antibiotics, making infections difficult to treat. The study will explore the use of different antibiotics to see if they can be effective alternatives to the usual treatments. The antibiotics being studied include Amoxicillin/Clavulanic acid, Ciprofloxacin, Sulfamethoxazole/Trimethoprim, Ertapenem, and Pivmecillinam.

The purpose of the study is to determine if these alternative antibiotics can safely and effectively treat febrile UTIs, which are UTIs accompanied by fever, caused by ESBL-producing bacteria. Participants in the study will initially receive intravenous antibiotics for a few days. Once their condition is stable, they will switch to oral antibiotics. The study will monitor the participants’ health to ensure the infection is resolved and no further antibiotic treatment is needed.

Throughout the study, participants will be observed for any signs of the infection returning and for any side effects from the antibiotics. The study will also check if the bacteria are still present in urine or stool samples after treatment. The goal is to find a reliable oral antibiotic treatment that can be used instead of the more commonly used antibiotics, which may not be effective against these resistant bacteria. The study will help doctors understand which antibiotics can be safely used to treat these challenging infections.