Assessment and management of acute epididymo-orchitis in the emergency department

Abstract

Aim
Acute epididymo-orchitis is a common presentation to the emergency department (ED). This project aimed to improve adherence to best practice standards in our ED.

Methods
A clinical practice guideline for emergency medicine physicians was developed in collaboration with urology and microbiology specialists. An audit was conducted before and after this guideline was implemented in our ED.

Results
51 patients were analysed in the baseline audit and there were 50 patients in the post intervention group. There was a statistically significant improvement in antibiotic prescriptions to patients diagnosed with epididymo-orchitis [74.5% (38/51) versus 96.0% (48/50), p <0.01] between the first and second loops. For those who required antibiotics, there was an increase in the adherence of antibiotic prescribing as per local guidance [63.1% (24/38) versus 97.9% (47/48), p <0.01] post the intervention.

Discussion
Development and introduction of a clinical practice guideline for acute epididymo-orchitis in our ED standardised care and improved conformity with best practice management.