From the Research
The initial approach to treating parotitis involves supportive care with adequate hydration, warm compresses applied to the affected gland, and pain management with acetaminophen or NSAIDs. For bacterial parotitis, empiric antibiotic therapy should be started promptly, typically with amoxicillin-clavulanate 875/125 mg orally twice daily for 7-10 days, or clindamycin 300-450 mg orally four times daily if penicillin-allergic, as suggested by 1. Some key points to consider in the management of parotitis include:
- Maintaining good oral hygiene and staying well-hydrated to promote salivary flow
- Using sialogogues (such as lemon drops or sugar-free candies) to stimulate saliva flow and prevent ductal stasis
- Considering surgical drainage if an abscess develops
- Being aware of the potential for viral parotitis (like mumps), which is managed symptomatically as antibiotics are ineffective, as noted in 2
- Recognizing that parotitis can be caused by a variety of factors, including bacterial and viral infections, and that the approach to treatment should be tailored to the underlying cause, as discussed in 3 and 4
- Considering the potential for anaerobic bacteria to be involved in cases of acute suppurative parotitis, as highlighted in 5, and selecting antibiotics accordingly. It's also important to note that the management of parotitis should prioritize preventing complications like abscess formation or sepsis, particularly in elderly or dehydrated patients, who are at higher risk for bacterial infections.