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Abstract：
The British Association for Sexual Health and HIV (BASHH) UK guideline for the management of epididymo-orchitis has been updated in 2020. It offers advice on diagnostic tests, treatment and health promotion principles in the effective management of epididymo-orchitis. Empirical treatment should be started in patients with objective swelling and tenderness on testicular examination. First-line empirical treatment for sexually acquired epididymo-orchitis has changed to ceftriaxone 1g intramuscularly and doxycycline. Higher dose of ceftriaxone in line with the BASHH 2018 gonorrhoea guideline ensures effective treatment of strains with reduced susceptibility. Ofloxacin or doxycycline is recommended in patients with epididymo-orchitis probably due to non-gonococcal organisms (e.g. negative microscopy for gram-negative intracellular diplococci or no risk factors for gonorrhoea identified). Where Mycoplasma genitalium is tested and identified, treatment should include an appropriate antibiotic (e.g. moxifloxacin). If enteric pathogens are a likely cause (e.g. older patient, not sexually active, recent instrumentation, men who practice insertive anal intercourse, men with known abnormalities of the urinary tract or a positive urine dipstick for leucocytes and nitrites), ofloxacin and levofloxacin are recommended. A clinical care pathway has been produced to simplify the management of epididymo-orchitis. A patient information leaflet has been developed.
摘要：
英国性健康与HIV协会（BASHH）英国附睾睾丸炎管理指南已于2020年更新。它提供诊断测试的建议，附睾睾丸炎有效管理的治疗和健康促进原则。对于睾丸检查有客观肿胀和压痛的患者，应开始经验性治疗。性获得性附睾睾丸炎的一线经验性治疗已改为肌肉注射头孢曲松1g和多西环素。符合BASHH2018淋病指南的较高剂量头孢曲松可确保有效治疗易感性降低的菌株。可能由于非淋球菌生物（例如，革兰氏阴性细胞内双球菌镜检阴性或未发现淋病的危险因素），建议附睾睾丸炎患者使用氧氟沙星或强力霉素。在对生殖支原体进行检测和鉴定的地方，治疗应包括适当的抗生素（例如莫西沙星）。如果肠道病原体是可能的原因（例如，老年患者，没有性活动，最近的仪器，练习插入肛交的男人，已知尿路异常或白细胞和亚硝酸盐尿液试纸阳性的男性），建议使用氧氟沙星和左氧氟沙星。已经产生了临床护理路径以简化附睾-睾丸炎的管理。已经开发了患者信息传单。
