How is acute epididymitis treated?

Updated: Apr 04, 2018
  • Author: Michelle DiMare, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Acute epididymitis is treated with antibiotic therapy, analgesics for pain control, and supportive care, which includes scrotal elevation and support, application of an ice pack, and, in some cases, spermatic cord block.

In prepubertal boys, a viral infection may be the most likely explanation, according to a British study. The authors note that management should be supportive and antibiotics reserved for patients with pyuria or positive cultures. Urodynamic studies and renal tract ultrasonography are suggested for those with recurrent epididymitis. [9]

In sexually active males 14 to 35 years of age, a single intramuscular dose of ceftriaxone with 10 days of oral doxycycline is the recommended treatment. In men who have anal intercourse, ceftriaxone with 10 days of oral levofloxacin or ofloxacin is recommended. In men older than 35 years, epididymitis is usually caused by enteric bacteria in the ejaculatory ducts caused by reflux of urine secondary to bladder outlet obstruction. In such cases, levofloxacin or ofloxacin is ordinarily used to treat these infections. [3]

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