From the Research
For a testicular abscess following prostate polyp resection, empiric antibiotic therapy should include broad-spectrum coverage with a combination of ceftriaxone 1-2g IV daily plus metronidazole 500mg IV every 8 hours, or piperacillin-tazobactam 4.5g IV every 6 hours as a single agent, as recommended by the most recent and highest quality study 1.
Key Considerations
- The infection likely resulted from bacterial seeding during the prostate procedure, with common pathogens including gram-negative enteric bacteria, anaerobes, and sometimes enterococci, as noted in 1.
- Blood cultures should be obtained before starting antibiotics, and the regimen should be adjusted based on culture results from the abscess drainage, as suggested by 2.
- Surgical drainage is typically necessary alongside antibiotics, as most testicular abscesses require intervention to remove purulent material, as indicated in 1.
- Pain management with acetaminophen or NSAIDs and scrotal support are important adjunctive measures, as mentioned in the example answer.
- Close follow-up with urology is essential to monitor treatment response and ensure complete resolution, as emphasized in the example answer.
Treatment Duration and Adjustment
- Treatment should continue for 2-4 weeks depending on clinical response, with transition to oral antibiotics like ciprofloxacin 500mg twice daily plus metronidazole 500mg three times daily once improvement is noted, as recommended in the example answer.
- The regimen should be adjusted based on culture results from the abscess drainage, as suggested by 2.