The European Association of Urology has published its 2026 Urological Infections Guidelines, based on a structured literature appraisal with recommendations graded on benefit, harm, evidence certainty and patient values.
The main changes are a restructuring around the new UTI classification system, a new chapter on diagnosis and management of genital herpes simplex, a new chapter on fungal UTI, and updated evidence and recommendations on antibiotic prophylaxis for prostate biopsy. Antimicrobial stewardship runs through antibiotic choice, dose and duration.
For Indian practice, where resistance to fluoroquinolones and third-generation cephalosporins is high, the stewardship emphasis and biopsy prophylaxis update are the most immediately relevant. Local antibiograms should still drive empirical choices.
- Review your prostate biopsy prophylaxis protocol against the updated recommendations.
- Prefer transperineal biopsy where available — it lowers infection risk.
- Match empirical UTI treatment to local resistance data, not only to guideline defaults.
- Consider fungal UTI in catheterised, diabetic or immunosuppressed patients with persistent symptoms.
- Take a sexual history in men with genital ulceration or urethritis.
Why it matters
Infection after prostate biopsy and resistant UTI are among the commonest avoidable harms in urology.
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