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Management of acute epididymitis: are European guidelines being followed?
Nigel E Drury1, Jonathan P Dyer, Nicole Breitenfeldt
1Department of Urology, Royal Hampshire County Hospital, Romsey Road, Winchester, Hampshire SO22 5DG, UK. ned@doctors.org.uk
Objective:
Acute epididymitis is increasing in men aged 35 years or under due to sexually-transmitted Chlamydia trachomatis. This study examines whether Urological surgeons are following European guidelines for the management of acute epididymitis in these patients.
Methods:
A postal questionnaire survey was conducted of specialists in Urology in two regions of the UK.
Results:
Of 79 completed replies, 41 (52%) take a detailed sexual history but only 34 (43%) refer patients to a Genitourinary medicine clinic. Quinolones are the most commonly prescribed first-line antibiotic by 56 (71%) respondents, principally ciprofloxacin.
Conclusions:
The current management of acute epididymitis in young men must be improved. Ciprofloxacin is not the optimal antimicrobial for the treatment of urogenital chlamydial infection. We recommend that all such patients be referred to local Genitourinary medicine services for contact-tracing and treatment of their sexual partners.
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