This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • bed rest
  • scrotal elevation
  • antibiotic treatment
    • empirical treatment is often with ciprofloxacin 500mg bd for 14 days
      • however treatment options must be chosen in consideration of regional antibiotic resistance patterns
    • the EAU have given therapy guidance for specific organisms (1,2):
      • Chlamydia trachomatis
        • first choice - quinolones with good activity against C. trachomatis (ofloxacin, levofloxacin)
        • second choice - doxycyline 2 × 100 mg for at least 14 days (macrolides are an alternative second choice treatment)
      • Enterobacteriaceae
        • first choice - quinolones
      • Neisseria gonorrhoeae - the EAU has no stated antibiotic regime
        • the German STD (Sexually Transmitted Diseases) Society has proposed the use of ciprofloxacin 500 mg as a single shot therapy, followed by doxycycline 2 × 100 mg/day for 2 weeks (1)
        • alternatively, ciprofloxacin 500 mg bd may be applied for the same time period as a monotherapy (1)

    • empirical antibiotic therapy has been suggested by Public Health England:
      • doxycycline 100mg BD for 10 to 14 days OR
      • ofloxacin 200mg BD for 14 days OR
      • ciprofloxacin 500mg BD for 10 days

  • drainage if there is abscess formation
  • possibly, pain relief with NSAID's e.g. mefenamic acid 500 mg tds
  • non - exertion for 1-3 weeks

Key points (3):

  • usually due to Gram-negative enteric bacteria in men over 35 years with low risk of STI
  • if under 35 years or STI risk, refer to GUM

Notes:

  • in case of C. trachomatis epididymitis, the sexual partner should also be treated (2)
  • EAU guidance suggests supportive therapy including bed rest, up-positioning of the testes and antiphlogistic medication
    • antiphlogistic therapy with methylprednisolone, 40 mg per day, followed by a dose reduction by half every second day may be considered (1,2)

Reference:


Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.