1. INTRODUCTION
1.1. Aim and objectives
This publication represents the updated European Association of Urology (EAU) Guidelines for Urological Infections. The aim is to provide practical recommendations on the prevention and treatment of urinary tract infections (UTIs) and male accessory gland infections. These guidelines also aim to address the important public health aspects of infection control and antimicrobial stewardship. Separate EAU guidelines are available addressing paediatric urological infections [1] and infections in patients with neurological urinary tract dysfunction [2].
It must be emphasised that clinical guidelines present the best evidence available to the experts, but following guideline recommendations will not necessarily result in the best outcome. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions - also taking personal values and references/individual circumstances of patients into account. Guidelines are not mandates and do not purport to be a legal standard of care.
1.2. Panel composition
The EAU Guidelines Panel on Urological Infections consists of an international multi-disciplinary group of urologists, with particular expertise in this area, an infectious disease specialist and a clinical microbiologist. All experts involved in the production of this document have submitted potential conflict of interest statements, which can be viewed on the EAU website Uroweb: http://uroweb.org/guideline/urological-infections/.
1.3. Available publications
A quick reference document, the Pocket Guidelines, is available in print. This is an abridged version, which may require consultation together with the full text version. Several scientific publications are also available. All documents are accessible through the EAU website Uroweb: http://uroweb.org/guideline/urological-infections/. A EAU Guidelines App for iOS and Android devices is also available containing the Pocket Guidelines, interactive algorithms and calculators, clinical decision support tools, guidelines cheat sheets and links to the extended guidelines.
1.4. Publication history
The Urological Infections Guidelines were first published in 2001. This 2025 document presents a limited update of the 2024 publication.
1.4.1. Summary of changes
The key changes and updates on the 2025 EAU guidelines on urological infections include the following:
- Introduction of a new UTI classification system. Changes are explained in detail in Section 3.1.
- Update of Section 3.4 on cystitis including the addition of a new Section 3.4.4 on non-antibiotic treatments for the management of cystitis.
- Update of the evidence and recommendations for immunomodulatory prophylaxis for recurrent UTIs in Section 3.5.3.3.2.
- Update of the evidence and recommendations in Section 3.7 addressing systematic UTIs.
- Update of the evidence in Sections 3.10 on urethritis and 3.12 on acute epididymitis.
- Introduction of a new Section, 3.15, on Herpes Simplex Virus (HSV).
- Update of the evidence and recommendations on prostate biopsy in Section 3.17.2.8.
- Update of the antibiotic dosages where applicable.