From the Research
Antibiotics, specifically cephalosporins and fluoroquinolones, are the primary treatment for bacterial salivary gland infections due to their favorable pharmacokinetics in saliva and effectiveness against common oral pathogens, as supported by the systematic review 1. The choice of antibiotics should be guided by the identification of the etiologic agent, with Staphylococcus aureus and anaerobic bacteria being the most common pathogens associated with acute bacterial infection 2. For penicillin-allergic patients, alternative antibiotics such as clindamycin or azithromycin may be considered. Steroids, such as prednisone, may be used in cases with significant inflammation causing severe pain or trismus, but their role is limited in primarily infectious conditions 3. Treatment should also include supportive measures such as:
- Adequate hydration
- Warm compresses
- Salivary massage
- Sialogogues (lemon drops or sugar-free candies) to stimulate saliva flow Patients should be advised to maintain good oral hygiene and increase fluid intake. If symptoms worsen or don't improve within 48-72 hours of antibiotic therapy, patients should seek further evaluation as surgical drainage may be necessary for abscess formation. The most recent study 4 highlights the importance of diagnosis and management of any underlying medical process in cases of sialadenosis, but this does not directly impact the primary treatment of bacterial salivary gland infections. Overall, the treatment approach should prioritize the use of effective antibiotics, supportive care, and consideration of the patient's overall condition to improve morbidity, mortality, and quality of life outcomes.