Document Detail


Management of epididymo-orchitis in primary care: results from a large UK primary care database.
MedLine Citation:
PMID:  20883615     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Epididymo-orchitis is a common urological presentation in men but recent incidence data are lacking. Guidelines for management recommend detailed investigation and treatment for sexually transmitted pathogens, such as Chlamydia trachomatis. Data from secondary care indicate that these guidelines are poorly followed. It is not known how epididymo-orchitis is managed in UK general practice.
AIM: To estimate the incidence of cases of epididymo-orchitis seen in UK general practice, and to describe their management.
DESIGN OF STUDY: Cohort study.
SETTING: UK general practices contributing to the General Practice Research Database (GPRD).
METHOD: Men, aged 15-60 years, consulting with a first episode of epididymo-orchitis between 30 June 2003 and 30 June 2008 were identified. All records within 28 days either side of the diagnosis date were analysed to describe the management of these cases (including location) and to compare this management with guidelines.
RESULTS: A total of 12 615 patients with a first episode of epididymo-orchitis were identified. The incidence was highest in 2004-2005 (25/10 000) and declined in the later years of the study. Fifty-seven per cent (6943) of patients were managed entirely within general practice. Of these, over 92% received an antibiotic, with ciprofloxacin being the most common one prescribed. Only 18% received a prescription for doxycycline. Most men, including those under 35 years, had no investigation recorded and fewer than 3% had a test for chlamydia.
CONCLUSION: These results indicate low rates of specific testing and treatment for sexually transmitted infections in males who attend general practice with symptoms of epididymo-orchitis. There is a need for further research to understand the pattern of care delivered in general practice.
Authors:
Amanda Nicholson; Greta Rait; Tarita Murray-Thomas; Gwenda Hughes; Catherine H Mercer; Jackie Cassell
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of general practice : the journal of the Royal College of General Practitioners     Volume:  60     ISSN:  1478-5242     ISO Abbreviation:  Br J Gen Pract     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-01     Completed Date:  2010-12-10     Revised Date:  2012-05-07    
Medline Journal Info:
Nlm Unique ID:  9005323     Medline TA:  Br J Gen Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  e407-22     Citation Subset:  IM    
Affiliation:
Division of Primary Care and Public Health, Brighton and Sussex Medical School, Mayfield House Room 322, University of Brighton, Falmer, Brighton BN1 9PH. a.c.nicholson@bsms.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anti-Bacterial Agents / therapeutic use*
Chlamydia Infections / diagnosis*,  epidemiology
Chlamydia trachomatis
Databases, Factual
Electronic Health Records
Epidemiologic Methods
Epididymitis / drug therapy*,  epidemiology,  microbiology
Family Practice
Great Britain / epidemiology
Humans
Male
Middle Aged
Orchitis / drug therapy*,  epidemiology,  microbiology
Young Adult
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents
Comments/Corrections

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