GENITOURINARY - Epididymitis Age <35 Years or Recent Sexual Contact (N. gonorrhoeae, C. trachomatis) General statement: Must rule out testicular torsion, a surgical emergency.

Ceftriaxone (IM)

(Rocephin^®)

Adolescents and Adult: 250 mg IM × 1 dose.

Important side effects: Pain at injection site.

Vials: 250 mg, 500 mg, 1,000 mg

Vials with 2.1 mL Lidocaine for IM injection: 500 mg, 1,000 mg

Administer with doxycycline. See below.

Doxycycline

(Vibramycin^®)

Generics available

Caps: 50 mg, 100 mg

Tabs: 100 mg

Adult: 100 mg PO twice daily for 10 days.

Administer with ceftriaxone. See above.

Food: May take with food if GI upset occurs. Take 1 hour before or 2 hours after antacids, iron, milk, or other dairy products. Take with full glass of water to prevent esophagitis.

Important side effects: Photosensitivity, use sunscreen. Esophagitis. May discolor fingernails.

Ofloxacin

(Floxin^®)

Tabs: 200 mg, 300 mg, 400 mg

Adult: 300 mg PO twice daily for 10 days.

Food: Take on empty stomach. Do not take within 2 hours of antacids, magnesium, calcium, zinc, iron, aluminum, sucralfate, vitamins, or mineral supplements.

Important side effects: Nausea, photosensitivity, dizziness.

GENITOURINARY - Epididymitis Age >35 Years or No Sexual Contact (Enterobacteriaceae)

Ciprofloxacin

(Cipro^®)

Tabs: 250 mg, 500 mg, 750 mg

Adult: 500 mg PO twice daily for 10-14 days.

Food: Take on empty stomach 1 hour before or 2 hours after a meal. May take with food if it causes GI upset, but avoid large amounts of dairy products.

May take 2 hours before or 6 hours after sucralfate, antacids, aluminum, magnesium, calcium, zinc, iron, sucralfate, vitamins, or mineral supplements.

Important side effects: Photosensitivity, dizziness.

Reduce dose in renal disease

(CrCl <50 mL/min).