2026 update on EAU Guidelines for Urological Infections

So many non-antimicrobial substances have also been tested, also against antibiotics, for example, against phosphomycin, which is used in cystitis, and can be actually recommended to reduce the symptoms of UTI and to prolong the UTI free rate, not only for prophylaxis, but also for the treatment of actual infections.

And besides antibiotics...

What is the repertoire containing that will allow us to prevent recurrent cystitis? Should it be always an antibiotic or are there new weapons that we might use? So, interesting

question, but make one step back.

Because we wanted to speak about the treatment of acute cystitis and the prevention of cystitis, recurrent cystitis is another topic.

So, let's start with the treatment of acute cystitis.

Of course, we have the antibiotics.

But now, as I said, we know antibiotics might not only do good things, they might harm our patients.

And more and more young female patients coming into my office are saying, I don't I don't want an antibiotic.

What could you offer me or offer me else? And so we must say we have many options.

So we have phytotherapeutics.

We have painkillers, NRAS, which are working fantastic.

And we have, of course, then other means like just weight to increase your fluid intake.

But if you ask me, I think the painkiller option is a very good option if you would not like to go for an antibiotic.

Of course, we have to inform our patients that they have a slight risk to develop an upper unit tract infection.

So it's about 5% of female patients coming with cystitis and a conservative approach and they develop pyelonephritis.

At least we have to inform the patients.

But all in all, it's a good means that we have other options.

Especially for the young females with cystitis.

Of course, not for the fragile, older patients with cystitis.

That's another topic, of course.

And for prophylaxis, what are the alternatives?

There is not much new, I must say.

Yeah.

Increasing the drinking amount.