Guidelines

Urological Infections

1. INTRODUCTION

1.1. Aim and objectives

This overview 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: https://uroweb.org/guidelines/urological-infections/panel.

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. All documents are accessible through the EAU website Uroweb: http://uroweb.org/guideline/urological-infections/.

1.4. Publication history

The Urological Infections Guidelines were first published in 2001. This 2024 document presents a limited update of the 2023 publication.

1.4.1. Summary of changes

Key changes in the 2024 guideline:

  • Section 3.3 - Asymptomatic Bacteriuria in Adults – This section has been extensively updated resulting in a new recommendation and a revised recommendation.

Recommendations

Strength rating

Do not screen or treat asymptomatic bacteriuria in patients prior to cardiovascular surgeries.

Weak

Screen for and treat asymptomatic bacteriuria in pregnant women with standard short course treatment or single dose fosfomycin trometamol.

Weak

  • Section 3.16.2.8 – Peri-Procedural Antibiotic Prophylaxis - Prostate Biopsy – The text of this section has been updated, following assessment of the literature.