Epididymo-orchitis
Treatment of bacterial epididymo-orchitis (STI cause suspected)
If STI suspected refer to GUM. I Consider important safety issues and potentially long-lasting side-effects prior to prescribing (see prescribing notes).
Doxycycline
Doxycycline 100mg capsules
100mg every 12 hours for 14 days
Prescribing Notes:
- Send an MSU in all patients and consider a urine NAAT to exclude chlamydia and/or gonorrhoea.
- Torsion of the spermatic cord (testicular torsion) is the most important differential diagnosis. It is a surgical emergency. It should be considered in all patients and should be excluded first as testicular salvage IS REQUIRED WITHIN 6 HOURS and becomes decreasingly likely with time.
- With any genital symptoms always consider the possibility of sexually transmitted infection (STI). People with risk factors should be screened for chlamydia, gonorrhoea, HIV and syphilis. Refer the individual and partners to sexual health service. Risk factors: younger patient, a new sexual partner or more than one sexual partner in the past year, lack of consistent condom use and a contact of a sexually transmitted infection.
History Notes
15/12/2021
East Region Formulary content agreed.
Treatment of bacterial epididymo-orchitis (UTI cause suspected)
In patients with no sexual risk factors, older patients, or catheter in situ treatment choice is based on urine culture, see prescribing notes.
Trimethoprim
Trimethoprim 200mg tablets
200mg every 12 hours for 14 days
Trimethoprim 50mg/5ml oral suspension sugar free
200mg every 12 hours for 14 days
Consider important safety issues and potentially long-lasting side-effects prior to prescribing (see prescribing notes).
Ofloxacin
Ofloxacin 200mg tablets
200mg every 12 hours for 14 days
Prescribing Notes:
- Refer to important safety information for all quinolones prior to prescribing.
- See MHRA Drug Safety Update January 2024: Fluoroquinolones must only be used in situations when other antibiotics, that are commonly recommended for the infection, are inappropriate such as:
- there is resistance to other first-line antibiotics recommended for the infection
- other first-line antibiotics are contraindicated in an individual patient
- other first-line antibiotics have caused side effects in the patient requiring treatment to be stopped
- treatment with other first-line antibiotics has failed.
- Send an MSU in all patients and consider a urine NAAT to exclude chlamydia and/or gonorrhoea.
- Torsion of the spermatic cord (testicular torsion) is the most important differential diagnosis. It is a surgical emergency. It should be considered in all patients and should be excluded first as testicular salvage IS REQUIRED WITHIN 6 HOURS and becomes decreasingly likely with time.
- With any genital symptoms always consider the possibility of sexually transmitted infection (STI). People with risk factors should be screened for chlamydia, gonorrhoea, HIV and syphilis. Refer the individual and partners to sexual health service. Risk factors: younger patient, a new sexual partner or more than one sexual partner in the past year, lack of consistent condom use and a contact of a sexually transmitted infection.
History Notes
14/03/2024
Prescribing information updated, MHRA DSU Fluroquinolone antibiotics, ERFC March 2024
15/12/2021
East Region Formulary content agreed.