From the Research
Antibiotic Recommendations for Epididymitis in Older Adults
- The recommended antibiotic for epididymitis in older adults is levofloxacin or ofloxacin alone, as enteric bacteria are the most common cause of epididymitis in this age group 1.
- Another study suggests that ciprofloxacin 500 mg orally twice daily is more effective than pivampicillin 700 mg orally twice daily for the treatment of epididymitis in men over 40 years of age, with a lower incidence of adverse events 2.
- It is also noted that fluoroquinolones, such as levofloxacin or ofloxacin, are effective and easy to use for the treatment of epididymitis in older adults, but vigilance is needed for the emergence of resistant strains 3.
- In general, the treatment of epididymitis in older men or men with urethral structural abnormalities should be directed toward the specific pathogen, which is often a classical urinary tract pathogen rather than a sexually transmitted pathogen 4.
- A study examining the management of acute epididymitis in men aged 35 years or under found that quinolones, principally ciprofloxacin, are the most commonly prescribed first-line antibiotic, but notes that ciprofloxacin is not the optimal antimicrobial for the treatment of urogenital chlamydial infection 5.