Tests and treatment of epididymo-orchitis

Epididymo-orchitis is a common urological problem. To see how it is managed in general practice, 12,615 cases were analysed in the UK General Practice Research Database. 

This showed few patients were investigated and although most men were given an antibiotic, it was often not a drug recommended for epididymo-orchitis.1

Therapeutic Guidelines: Antibiotic, version 14 gives clear advice on how  epididymo-orchitis should be managed. All patients need a microscopy and culture of their urine. 

Sexually active men should be tested for Chlamydia trachomatis and Neisseria gonorrhoeae.

Men with sexually acquired epididymo-orchitis can be treated empirically with intramuscular or intravenous ceftriaxone for three days, combined with a single dose of oral azithromycin, plus either doxycycline for 14 days or another single dose of azithromycin one week later.

In older men and prepubertal boys, epididymo-orchitis is likely to