From the Research
Sialadenitis treatment should prioritize the use of cephalosporins or fluoroquinolones as the primary antibiotic treatment, as they achieve the highest concentrations in saliva and cover the spectrum of bacteria implicated in the condition, as supported by the most recent and highest quality study 1. The management of sialadenitis involves addressing the underlying cause and managing symptoms. For acute bacterial sialadenitis, antibiotics are the primary treatment.
- The choice of antibiotic should be based on the most recent evidence, which suggests that cephalosporins and fluoroquinolones are the most effective options due to their favorable pharmacokinetics in saliva 2.
- Supportive measures include hydration, warm compresses, salivary gland massage, and pain management with NSAIDs like ibuprofen or acetaminophen.
- Sialogogues such as lemon drops or sugar-free candies can stimulate saliva flow to help flush out debris and bacteria.
- For severe cases or abscess formation, surgical drainage may be necessary.
- Chronic sialadenitis may require sialendoscopy to remove stones or strictures, or in refractory cases, gland removal.
- Autoimmune-related sialadenitis (as in Sjögren's syndrome) requires immunomodulatory therapy.
- Maintaining good oral hygiene, staying well-hydrated, and avoiding smoking are essential preventive measures.
- Prompt recognition and treatment of the condition can prevent the development of complications, and family physicians can play an important role in the diagnosis and management of sialadenitis 1.