Clinical recommendation	Evidence rating	References
If testicular torsion is suspected, the patient should receive urgent referral to a urologist for possible surgery.	C	12
Most patients with epididymitis and orchitis can be treated in an outpatient setting with close follow-up.	C	2–4
If epididymitis is thought to be caused by gonococcal or chlamydial infection, treatment should include ceftriaxone (Rocephin), a single 250-mg dose intramuscularly, and doxycycline (Vibramycin), 100 mg orally twice daily for 10 days. Azithromycin (Zithromax), a single 1-g dose orally, may be substituted for doxycycline if treatment compliance is questionable.	C	12
If epididymitis is thought to be caused by enteric organisms (e.g., coliform bacteria), treatment should include ofloxacin (Floxin; brand no longer available in the United States), 300 mg orally twice daily for 10 days, or levofloxacin (Levaquin), 500 mg orally once daily for 10 days.	C	12