This protocol covers epididymo-orchitis in which a sexually transmitted infection (STI) is suspected, none of the recognised gonorrhoea risk factors are present, and M. genitalium has not been identified. A targeted antibiotic approach applies in this specific context.
This regimen is indicated when all of the following risk factors for gonorrhoea are confirmed absent:
Management involves a combination of antibiotic agents given together. The full protocol specifies the exact agents, their doses, routes, and duration — access the complete regimen below.
Sexually transmitted epididymo-orchitis
Where gonorrhoea is considered unlikely, urethral/FPU microscopy negative for Gram-negative intracellular diplococci, no risk factors for gonorrhoea identified (absence of all of the following – a purulent urethral discharge, known contact of a gonorrhoeal infection, men who have sex with men, black ethnicity) and in countries/populations where there is known very low gonorrhoea prevalence, omitting ceftriaxone or using ofloxacin could be considered.
Ceftriaxone 500 mg intramuscular injection IIIB PLUS Doxycycline 100 mg twice daily for 10–14 days IIIB
At three days if there is no improvement in symptoms, the patient should be seen for clinical review and the diagnosis should be reassessed.
At two weeks to assess for treatment compliance, assessment of symptoms and partner notification.
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