Epididymoorchitis medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]
Overview
Management of epididymoorchitis consists mainly of conservative measures, including bed rest and limitation of physical activity, use of cold packs, analgesia and non-steroidal anti-inflammatory drugs (NSAIDs). In addition, appropriate antibiotic therapy should be initiated if the cause of epididymoorchitis is bacterial.[1][2][3]
Medical Therapy
Management of epididymoorchitis consists mainly of conservative measures, including:[1][2][3]
- Bed rest and limitation of physical activity
- Use of cold packs
- Analgesia
- Non-steroidal anti-inflammatory drugs (NSAIDs)
If acute epididymitis is most likely caused by chlamydia or gonorrhea
- Preferred regimen: Ceftriaxone 500mg IM single dose PLUS doxycycline 100mg PO bid for 10 days.[4]
If acute epididymitis most likely caused by chlamydia, gonorrhea, or enteric organisms (men who practice insertive anal sex)
- Preferred regimen: Ceftriaxone 500mg IM single dose PLUS levofloxacin 500mg PO qd for 10 days.[4]
If acute epididymitis most likely caused by enteric organisms only
- Preferred regimen: Levofloxacin 500mg PO qd for 10 days.[4]
- If patient weights more than 150kg - give ceftriaxone 1gr IM single dose.
Antibiotics are not necessary if the underlying etiology is likely viral such as mumps orchitis or other viral epididymoorchitis.
References
- ↑ 1.0 1.1 Trojian TH, Lishnak TS, Heiman D (2009). "Epididymitis and orchitis: an overview". Am Fam Physician. 79 (7): 583–7. PMID 19378875.
- ↑ 2.0 2.1 Stewart A, Ubee SS, Davies H (2011). "Epididymo-orchitis". BMJ. 342: d1543. PMID 21490048.
- ↑ 3.0 3.1 Tracy CR, Steers WD, Costabile R (2008). "Diagnosis and management of epididymitis". Urol. Clin. North Am. 35 (1): 101–8, vii. doi:10.1016/j.ucl.2007.09.013. PMID 18061028.
- ↑ 4.0 4.1 4.2 Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I; et al. (2021). "Sexually Transmitted Infections Treatment Guidelines, 2021". MMWR Recomm Rep. 70 (4): 1–187. doi:10.15585/mmwr.rr7004a1. PMC 8344968 Check
|pmc=value (help). PMID 34292926 Check|pmid=value (help).