European Association of Urology Guidelines on Urological Infections: Summary of the 2026 Guidelines

Abstract

Background and objective

Urological infections significantly impact individuals’ well-being and quality of life due to their widespread occurrence and diverse clinical manifestations. This work aims to provide evidence-based guidance on diagnosing, treating, and preventing urinary tract infections (UTIs) and male accessory gland infections, while addressing crucial public health aspects related to infection control and antimicrobial stewardship.

Methods

For the 2026 Urological Infections Guidelines, new and relevant evidence was identified, collated, and appraised through a structured assessment of the literature. Databases searched included Medline, EMBASE, and the Cochrane Library. Recommendations within the Guidelines were developed by the panels to prioritise clinically important care decisions. The strength of each recommendation is determined by the balance between desirable and undesirable consequences of alternative management strategies, the quality of the evidence (including certainty of estimates), and the nature and variability of patient values and preferences.

Key findings and limitations

Key recommendations emphasise the importance of thorough medical history and physical examination for patients with urological infections. The guidelines stress the role of antimicrobial stewardship to combat the rising threat of antimicrobial resistance, providing recommendations for antibiotic selection, dosing, and duration based on the latest evidence. Key updates in the 2026 Urological Infections Guidelines summary include: comprehensive restructuring of the guideline framework in alignment with the new classification system for UTIs; the addition of a new chapter on the diagnosis and management of Herpes simplex virus; the addition of a new chapter on the diagnosis and treatment of fungal UTIs; and an update of the evidence and recommendations on periprocedural antibiotic prophylaxis for prostate biopsy.

Conclusions and clinical implications

This overview of the 2026 European Association of Urology (EAU) guidelines offers valuable insights into the classification, diagnosis, and treatment of urological infections and is designed to be effectively integrated into clinical practice.