In epididymitis, what is the initial step in management?

• A. Oral doxycycline
• B. Corticosteroid injection
• C. Surgical referral
• D. Darvocet

Answer: (A)

Epididymitis should be managed first with antibiotics that aggressively target the common infectious causes, especially in younger sexually active men where Chlamydia trachomatis is a frequent culprit. Starting oral doxycycline addresses the most likely organism and helps rapidly curb inflammation and infection. In clinical practice this empiric antibiotic approach is often augmented to cover gonorrhea as well, but the key step is initiating antibiotic therapy promptly rather than waiting for test results. Corticosteroid injections don’t treat the infection, surgical referral is reserved for complications such as abscess orFailed medical therapy, and Darvocet has no role in treating an infectious epididymitis. Supportive measures like scrotal elevation and analgesia help with symptoms while antibiotics take effect.