Microbiological specimens
- Please refer to individual Trust protocols and procedures for Genito-Urinary Medicine. BASHH guidelines.
- High level of resistance to Penicillin and Quinolones which favour single dose Ceftriaxone for Gonorrhoea.
- The choice of agent should take into account the patient’s risk for C. difficile infection.
Most common cause of Epididymo-orchitis is Mumps. Please note this is a notifiable disease to Public Health England.
Common Pathogen(s)
Chlamydia trachomatis
Antibiotic – 1st line |
2nd Line |
Comment
Refer to GUM and treat sexual partners.
Swabs from women or urine from both men and women to be tested by PCR for gonorrhoea (swabs superior sample for women) and chlamydia (one yellow topped bottle)
Women:
Cervical or vulvo-vaginal swab.
First voided urine sample.
Men:
First voided urine sample.
Urethral swab.
Often co-infected with Chlamydia dual treatment may be required
Common Pathogen(s)
Neisseria gonorrhoeae.
Antibiotic – 1st line |
2nd Line |
Comment
Refer to GUM and treat sexual partners.
Swabs from woman or urine from both men and women to be tested by PCR for gonorrhoea (Swabs superior for woman) and chlamydia (one yellow topped bottle).
Women:
Cervical swab.
Rectal / oropharnygeal tests if symptomatic / at risk at these sites.
Men:
Urethral swab.
Rectal/ oropharnygeal tests if symptomatic at these sites.
See urinary section
Common Pathogen(s)
Neisseria gonorrhoeae;
Chlamydia trachomatis;
Mixed Anaerobes;
Enteric organisms.
Antibiotic – 1st line Oral switch for total of 14 days: |
2nd Line Clindamycin 900mg q8h IV 5mg/kg IV q24h (max 500mg): if <70 years and CrCl≥30mL/min or IV for 24hours after clinical improve and then switch to oral: Oral switch: Or Doxycyline 100mg PO 12h Metronidazole 400mg q12h PO to complete14days course |
Comment
As above for Chlamydia and Gonorrhoea
Doxycycline and Ofloxacin contraindicated in pregnancy.
Common Pathogen(s)
Herpes simplex virus
(HSV-1 and HSV-2).
Antibiotic – 1st line |
Comment
Refer to GUM
Oral antivirals are indicated within 5 days of the start of the episode and while new lesions are forming.
Swab taken from base of lesion.
Antibiotic – 1st line |
Common Pathogen(s)
Candida albicans.
Antibiotic – 1st line |