- Epididymitis:
- Affected age group: < 35
years old
- Causative agent(s):
 Chlamydia
trachomatis (more
often)- Neisseria
gonorrhoeae
- Older
age group or those who have had urinary
tract instrumentation:
- Causative agents:
- enteric
gram-negative bacilli
- may
also cause urethritis or
epididymitis in men
practicing unprotected,
inserted anal intercourse
- Pseudomonas
- Drug of choice:
- ofloxacin (Floxin)
- may be used in the
absence of culture data
- Alternative agent:
- ceftriaxone (Rocephin)
(single IM dose followed by 10
day treatment with doxycycline (Vibramycin,
Doryx)
- Pelvic Inflammatory
Disease
- Causative Agents
- Chlamydia
trachomatis and Neisseria
gonorrhoeae: responsible for
about 2/3 of active cases
- Other organisms
included Mycoplasma hominis
(other facultative agents and
anaerobic bacteria can be
present)
- Inpatients:
- Drugs of
choice:
- cefotetan (Cefotan) or
cefoxitin (Mefoxin) plus
doxycycline (Vibramycin,
Doryx, contraindicated in
pregnancy)
- doxycycline (Vibramycin,
Doryx) alone --
contraindicated in
pregnancy
- Or
- clindamycin
(Cleocin) +gentamicin
(Garamycin), followed by
doxycycline (Vibramycin, Doryx)
- Alternative agents:
- ofloxacin (Floxin) +
metronidazole (Flagyl)
- ampicillin
(Principen,
Omnipen)/sulbactam +
doxycycline (Vibramycin, Doryx)
- ciprofloxacin +
doxycycline (Vibramycin,
Doryx,contraindicated in
pregnancy) +
metronidazole (Flagyl)
- all combinations
continued until
improvement is observed:
then doxycycline
(Vibramycin, Doryx,
contradicted in
pregnancy) for a 14 day
time course
- Outpatients
- Drugs of
choice:
- ofloxacin (Floxin,
contraindicated in
pregnancy) +
metronidazole (Flagyl)
- Or
- ceftriaxone (Rocephin)
Or
- cefoxitin (Mefoxin) +
probenecid (Benemid)--
either cephalosporin,
ceftriaxone (Rocephin) or
cefoxitin (Mefoxin),
followed by doxycycline
(Vibramycin, Doryx,
contraindicated in
pregnancy)
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