What is the treatment for sialadenitis (inflammation of the salivary gland)?

From the Research

Treatment for sialadenitis should prioritize a combination of hydration, pain management, and addressing the underlying cause, with antibiotics such as cephalosporins or fluoroquinolones being the most effective options for bacterial sialadenitis, as they achieve the highest concentrations in saliva and cover the spectrum of all bacteria implicated in the condition 1.

Initial Management

Initial management of sialadenitis includes:

• Increasing fluid intake to promote saliva flow
• Applying warm compresses to the affected area
• Taking over-the-counter pain relievers such as ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours)
• Gentle massage of the affected salivary gland toward the duct opening to help release blockages

Antibiotic Treatment

For bacterial sialadenitis, antibiotics are necessary, and the most effective options are:

• Cephalosporins, which achieve the highest concentrations in saliva 1
• Fluoroquinolones, which also achieve high concentrations in saliva and cover the spectrum of all bacteria implicated in sialadenitis 1
• Amoxicillin-clavulanate (875/125mg twice daily for 7-10 days) or clindamycin (300mg four times daily for 7-10 days) if penicillin-allergic, although these may not be as effective as cephalosporins or fluoroquinolones 2, 3

Referral to Specialist

For severe or recurrent cases, referral to an otolaryngologist may be necessary for possible:

• Sialendoscopy
• Stone removal
• Rarely, gland excision Sialadenitis occurs due to ductal obstruction or infection of salivary glands, most commonly the parotid or submandibular glands, and prompt treatment helps prevent complications like abscess formation or chronic inflammation 4, 5.