Epididymitis

Antimicrobial prescribing: NHS Grampian, Orkney & Shetland
NHS Grampian

Micro Organisms

Neisseria gonorrhoea, Chlamydia trachomatis, Gram negative organisms

Duration

10-14 days

Notes

Therapy

  • Send MSSU or catheter urine sample
  • Send blood for culture if pyrexial
  • Send first pass urine sample if suspected gonorrhoea
  • If STD is suspected patients should be referred to Sexual Health Service (0345 337 9900) for partner notification and advice if required.

Notes:

35 years or younger OR High risk of STD, suspected Neisseria gonorrhoea

Therapy

IM Ceftriaxone 500mg single dose

+

Oral Doxycycline 100mg 12 hourly for 10 - 14 days

Notes:

35 years or younger OR High risk of STD, suspected Neisseria gonorrhoea - penicillin allergy

Therapy

oral Ciprofloxacin 500mg single dose

+

oral Doxycycline 100mg 12 hourly for 10 - 14 days

Notes:

Ciprofloxacin: check important safety information in BNF & give MHRA patient information leaflet to patient

Suspected Chlamydia trachomatis

Therapy

Oral Doxycycline 100mg 12 hourly for 10 - 14 days

Notes:

Suspected Gram negative enteric organisms plus Chlamydia trachomatis (low risk for Neisseria gonorrhoea)

Therapy

Oral Ofloxacin 200mg 12 hourly for 14 days

Notes:

Avoid ofloxacin in frail elderly patients where possible due to CDI risk. Check important safety information in BNF & give MHRA patient information leaflet to patient

Older than 35 years or low risk of STD, suspected gram negative organisms

Therapy

Oral Ciprofloxacin 500mg 12 hourly for 10 days

Notes:

Avoid ciprofloxacin in frail elderly patients where possible due to CDI risk. Check important safety information in BNF & give MHRA patient information leaflet to patient

Notes

Consider immune deficiency and testing for HIV.