From the Research
The treatment of acute parotitis primarily involves supportive care, antibiotics for bacterial cases, and addressing the underlying cause, with the most recent and highest quality study 1 emphasizing the importance of vaccination and supportive care for viral parotitis, such as mumps. The initial management of acute parotitis includes:
- Adequate hydration
- Warm compresses to the affected area
- Pain control with acetaminophen or NSAIDs For bacterial parotitis, empiric antibiotic therapy should be started with agents effective against Staphylococcus aureus and oral flora, such as amoxicillin-clavulanate 875/125 mg twice daily for 7-10 days, or clindamycin 300-450 mg four times daily if penicillin-allergic, as suggested by 2. Severe cases may require intravenous antibiotics like ampicillin-sulbactam 3 g every 6 hours. Parotid gland massage and sialagogues (lemon drops or sugar-free gum) help stimulate saliva flow and prevent ductal obstruction. Viral parotitis (mumps) is managed symptomatically as antibiotics are ineffective, and treatment is generally supportive, with emphasis on proper isolation to prevent widespread outbreaks, as noted in 1. If an abscess develops, surgical drainage may be necessary, as indicated by 3. Patients should maintain good oral hygiene and stay well-hydrated to prevent recurrence. Treatment effectiveness is based on addressing the inflammatory process while eliminating infection, as the parotid gland's anatomical location and ductal system make it susceptible to ascending infections from the oral cavity, as discussed in 4.