Antibiotics are the cornerstone of treatment for acute epididymitis. The choice of antibiotic depends on the likely cause of the infection. For sexually active men, doctors usually prescribe a combination of antibiotics to cover both chlamydia and gonorrhea. This might include a single injection of ceftriaxone plus a 10-day course of doxycycline pills. For men who aren't sexually active, antibiotics that target common urinary tract bacteria are used, such as levofloxacin or trimethoprim-sulfamethoxazole.

While antibiotics fight the infection, other measures help manage symptoms. Over-the-counter pain relievers like ibuprofen can reduce pain and inflammation. Applying ice packs to the scrotum can also help with swelling and discomfort. Wearing supportive underwear and elevating the scrotum when lying down can provide relief. It's important to rest and avoid strenuous activities until symptoms improve.

Most cases of epididymitis can be treated at home, but sometimes hospital care is necessary. This might be needed if you have severe pain, high fever, or signs of a more serious infection. In the hospital, you might receive intravenous antibiotics and fluids. If an abscess (a pocket of pus) forms, it may need to be drained surgically.

After starting treatment, symptoms should start to improve within a few days. It's important to finish all prescribed antibiotics, even if you feel better. Your doctor may want to see you for a follow-up visit to ensure the infection has cleared. If the epididymitis was caused by a sexually transmitted infection, your sexual partners will need to be treated too. Using condoms and practicing safe sex can help prevent future episodes.

With proper treatment, most men recover fully from acute epididymitis without long-term problems.