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Epididymitis is usually caused by a bacterial infection that starts in the urethra, bladder, or prostate and ultimately spreads to the epididymis. Depending on the patientâs age, the most common causes of epididymitis are sexually transmitted infection, an enlarged prostate gland, or urinary tract infections.
For acute epididymitis most likely caused by sexually-transmitted chlamydia and gonorrhea and enteric organisms (men who practice insertive anal sex) 1  Ceftriaxone 250 mg IM in a single dose. PLUS. 2  Levofloxacin 500 mg orally once a day for 10 days. OR. 3  Ofloxacin 300 mg orally twice a day for 10 days.