From the Research
The treatment for adult parotitis should prioritize supportive care, with empiric antibiotic therapy for bacterial cases, and symptomatic management for viral cases, as the cornerstone of management. For bacterial parotitis, antibiotics that cover Staphylococcus aureus, such as amoxicillin-clavulanate (875/125 mg twice daily for 7-10 days) or clindamycin (300-450 mg four times daily for 7-10 days) if penicillin-allergic, should be initiated promptly 1. Viral parotitis is managed symptomatically with hydration, warm compresses, analgesics like acetaminophen (650 mg every 6 hours as needed), and anti-inflammatory medications such as ibuprofen (400-600 mg every 6-8 hours with food). Regardless of cause, adequate hydration, warm compresses to the affected area, gentle massage of the gland, and sialagogues (substances that promote salivation) like lemon drops or sugar-free gum can help relieve symptoms by promoting saliva flow and reducing swelling.
Some key points to consider in the management of adult parotitis include:
- The importance of maintaining hydration and promoting salivation to reduce swelling and relieve symptoms
- The need for prompt antibiotic therapy in cases of bacterial parotitis to prevent complications such as abscess formation
- The role of surgical drainage in severe cases or those with abscess formation
- The importance of treating underlying conditions such as Sjögren's syndrome, sarcoidosis, or medication-induced parotitis for long-term management
- The potential benefits of interventional radiology procedures, such as stone removal or duct dilation, in certain cases of recurrent parotitis 2
It is essential to note that the management of adult parotitis should be tailored to the individual patient's needs and underlying cause of the condition. Prompt treatment is crucial to prevent complications, such as abscess formation, facial nerve paralysis, or spread of infection to adjacent structures. The most recent and highest quality study available should guide treatment decisions, with consideration of the patient's specific circumstances and medical history 1.