Article Text

Download PDFPDF

P12 Management of acute epididymo-orchitis: ad hoc or evidence based?
  1. Thomas Stonier,
  2. Philip Gardner,
  3. Rohit Srinivasan,
  4. David Curry,
  5. Paras Singh
  1. Royal Free Hospital, London, UK


Background/introduction A clear guideline exists for the management of acute epididymo-orchitis. Both the EAU and our local trust antibiotics guidelines state that patients aged 35 or younger, or those with suspected STI, be prescribed single dose ceftriaxone with a course of doxycycline; while patients over 35 receive ciprofloxacin. All patients should be investigated for an STI.

Aim(s)/objectives This study looks at how the guidelines are being implemented in the accident and emergency (A&E) department of a large teaching hospital.

Methods We reviewed the A&E notes of patients attending the department with suspected epididymo-orchitis between 1st May and 28th October 2014. 56 patients’ notes were scrutinised for a record of sexual history, investigations performed and final management.

Results Of the 56-patient study cohort, 20 were aged ≤35 years (median age 51; range 36–84 years) and 36 >35 years (median age 25; range 20–34 years). A sexual history was documented in 26 (46%) cases, with one patient tested for presence of STI and six (10%) advised to visit the GUM clinic. Antibiotics were prescribed for 55 patients; 28 (50%) received ciprofloxacin (mean age 53.5, range 21–91 years), two (aged 25 and 27 years) doxycycline, 13 (23%) both ciprofloxacin and doxycycline (mean age 36.5, range 20–63 years), and 12 (21%) received different antibiotics (mean age 50.8, range21–83 years). 17 patients (30%) were prescribed antibiotics correctly according to the guideline.

Discussion/conclusion Despite a robust and clear guideline on epididymo-orchitis our results show that antibiotic prescribing is often incorrect. Furthermore, the work-up for an STI as a cause of epididymo-orchitis is incomplete.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.