The European Association of Urology has published the summary of its 2026 urological infections guidelines, covering diagnosis, treatment and prevention of urinary tract infection and male accessory gland infection, with antimicrobial stewardship as an explicit organising principle rather than an afterthought.
Four changes are highlighted. The framework has been comprehensively restructured to align with a new classification system for urinary tract infections — which is the substantial change, since classification determines which patients are considered to have the same condition and therefore which evidence applies to them. There are new chapters on the diagnosis and management of herpes simplex virus and on fungal urinary tract infection, neither previously covered. And recommendations on periprocedural antibiotic prophylaxis for prostate biopsy have been updated, which matters in a procedure where post-biopsy sepsis has been rising with fluoroquinolone resistance.
The stewardship framing deserves attention beyond Europe. Recommendations on antibiotic selection, dosing and duration are where guidelines most often diverge from local resistance patterns, and where following international guidance uncritically can be worse than following local antibiograms. Read the structure and the diagnostic recommendations as broadly applicable, and check the specific antibiotic choices against your own institution's resistance data before adopting them.
- Framework restructured around a new UTI classification system
- New chapters on herpes simplex virus and on fungal urinary tract infection
- Updated periprocedural antibiotic prophylaxis for prostate biopsy
- Check specific antibiotic recommendations against local resistance data
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