The 2024 European guideline on the management of epididymo-orchitis.

The European guideline on the management of epididymo-orchitis has been updated in 2024. This guideline offers advice on the diagnosis, investigation, treatment and follow-up for the management of epididymo-orchitis. For treatment of patients with a history suggestive of sexually transmitted pathogens-ceftriaxone dose increased to 1 g intramuscularly (IM) single dose alongside doxycycline. The use of dual therapy with azithromycin is no longer recommended, unless cefixime is being given as an alternative to ceftriaxone. For treatment of patients with a history including risks for both sexually transmitted and enteric pathogens-ceftriaxone IM single dose and either ofloxacin or levofloxacin is recommended. Where enteric pathogens are suspected as the likely cause, either ofloxacin or levofloxacin is recommended as monotherapy. This guideline covers a range of clinical scenarios, including rarer and non-sexually transmitted causative agents.