From the FDA Drug Label
Clindamycin is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin
The best antibiotic for a parotid gland stone with infection is not explicitly stated in the provided drug label. No conclusion can be drawn about the best antibiotic for this specific condition. The label discusses the use of clindamycin for various infections, but it does not directly address parotid gland stone infections 1.
From the Research
For a parotid gland stone with infection, the best antibiotic treatment is amoxicillin-clavulanate (Augmentin) 875/125 mg orally twice daily for 7-10 days, as it provides broad-spectrum coverage against the mixed oral flora, including Staphylococcus aureus, Streptococcus viridans, and anaerobes, which are commonly involved in such infections 2. The choice of antibiotic is guided by the identification of the etiologic agent, and in the absence of culture and sensitivity results, empiric therapy with broad-spectrum coverage is necessary 3. Some key points to consider in the management of parotid gland stone with infection include:
- The infection typically involves mixed oral flora, which is why broad-spectrum coverage is necessary 4
- Alternative options include clindamycin 300-450 mg orally four times daily if the patient has a penicillin allergy
- In severe cases requiring hospitalization, IV antibiotics such as ampicillin-sulbactam 3 g every 6 hours or clindamycin 600-900 mg every 8 hours may be needed
- Along with antibiotics, supportive measures are important, including warm compresses, hydration, sialogogues (lemon drops or sour candy) to stimulate saliva flow, massage of the gland, and pain management with NSAIDs or acetaminophen
- Definitive treatment often requires addressing the stone itself through minimally invasive techniques like sialendoscopy or, in some cases, surgical removal 5
- Patients should be advised to follow up if symptoms don't improve within 48-72 hours of starting antibiotics, as this may indicate abscess formation requiring drainage 6