Epididymo-Orchitis Secondary to Enteric Organisms: Treatment in Men with Obstructive Urinary Disease, Urinary Instrumentation, or Insertive Anal Intercourse
In some presentations of epididymo-orchitis, gram-negative enteric bacteria are the most probable causative organisms. Identifying the correct patient risk profile is essential to directing appropriate treatment.
This protocol applies when epididymo-orchitis is most likely secondary to enteric organisms. Key risk factors include obstructive urinary disease, prior urinary tract surgery or instrumentation, and insertive anal intercourse — each of which increases the probability of gram-negative enteric pathogens as the underlying cause.
Treatment is directed at the likely enteric causative organism and involves a defined course of oral antibiotic therapy from an antimicrobial class with appropriate gram-negative enteric coverage. The complete regimen, including options and duration, is available in the full protocol.
Treatment goals: Improvement in symptoms should be evident within three days. Significant improvement in both symptoms and signs is expected following completion of the full course of therapy.
References
- DOI: 10.1177/0956462417699356
- Gram-negative enteric organism risk factors include obstructive urinary disease, urinary tract surgery or instrumentation.
- Gram-negative enteric organisms: in men engaging in insertive anal intercourse.
- Ofloxacin 200 mg twice daily for 14 days IIB; OR Levofloxacin 500 mg once daily for 10 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.
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