This protocol covers sexually transmitted epididymo-orchitis in patients where gonorrhoea is considered a likely causative organism. The approach differs from standard epididymo-orchitis management and is driven by the presence of specific clinical risk factors.
When gonorrhoea is considered likely, management requires a combination antibiotic regimen that provides optimal cover against gonococcal infection, together with general supportive measures. The complete agent selection, dosing, and sequencing are available in the full protocol.
Clinical target: Improvement in symptoms at three days.
DOI: 10.1177/0956462417699356
In patients where gonorrhoea is considered likely (see risk factors above) azithromycin should be added to ceftriaxone and doxycycline to provide optimal antibiotic cover.
General advice: analgesia, rest and scrotal support.
At three days if there is no improvement in symptoms, the patient should be seen for clinical review and the diagnosis should be reassessed.
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