Epididymitis and/or orchitis

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Required Investigations

  • Combined Chlamydia/Gonorrhoea NAAT test on first pass urine (ensure correct sample container used see STI testing)
  • Urine for culture (preferably mid-stream urine)
  • Consider HIV and syphilis testing on blood

Antimicrobial recommendation

Recommended total duration: 14 days

Treatment for epididymitis- orchitis infections likely enteric pathogen (UTI cause suspected in patients with no sexual risk factors i.e., older patients, or catheter in situ treatment based in urine culture):

Ofloxacin 200mg orally every 12 hours (*if manufacturer unable to supply 200mg strength, 400mg every 12 hours is acceptable) 

OR

Trimethoprim 200mg orally every 12 hours 

 Treatment for epididymitis-orchitis infections likely STI cause:

Likely caused only by Chlamydia:

Doxycycline 100mg orally twice daily for 14 days

Likely caused by Chlamydia and gonorrhoea:

Doxycycline 100mg orally every 12 hours for 14 days

AND

Ceftriaxone 1000mg orally as a single dose IM.

 

 

Notes

In all cases obtain a sexual history.

Refer all High Risk Patients to the Chalmers Centre for treatment (Walk-in appointments between 8.30am and 10am Mon to Fri):

  • Men who have sex with men (MSM)
  • Sex workers 

Consider mumps for patients with orchitis for advice speak to Virology.

Likely organisms: Sexually transmitted organisms as well as organisms that cause urinary tract infections.