From the Guidelines
Treatment for parotitis primarily involves managing symptoms and addressing the underlying cause, with a focus on rest, hydration, and pain management for viral cases, and antibiotics for bacterial cases. For viral parotitis, such as mumps, treatment includes rest, adequate hydration, soft diet, warm or cold compresses to reduce swelling, and pain relievers such as acetaminophen (500-1000mg every 6 hours) or ibuprofen (400-600mg every 6-8 hours) 1. It is essential to note that mumps can present with various complications, including orchitis, viral meningitis, and permanent hearing loss, as highlighted in a study on infectious diseases associated with organized sports and outbreak control published in Pediatrics in 2017 1.
Key considerations in the treatment of parotitis include:
- Identifying the underlying cause, whether viral or bacterial, to guide treatment
- Providing supportive care, such as hydration and pain management, to alleviate symptoms
- Using antibiotics, such as amoxicillin-clavulanate (875/125mg twice daily for 7-10 days) or clindamycin (300-450mg four times daily for 7-10 days), for bacterial parotitis
- Considering surgical intervention for complications like abscesses or persistent cases
- Addressing underlying conditions, such as Sjögren's syndrome or sialolithiasis, in cases of chronic or recurrent parotitis
In terms of specific treatment approaches, the use of antibiotics is crucial in bacterial parotitis, while supportive measures like gentle massage of the gland, sialogogues, and good oral hygiene are important for overall management. Additionally, pain management with acetaminophen or ibuprofen can help alleviate discomfort associated with parotitis, as noted in the context of managing symptoms for conditions like mumps 1.
From the Research
Treatment Options for Parotitis
- The treatment for parotitis typically involves maintenance of hydration and administration of parenteral antimicrobial therapy 2.
- The choice of antimicrobial depends on the etiologic agent, and surgical drainage is required once an abscess has formed 2, 3.
- Early and proper antimicrobial therapy may prevent suppuration, and initial empiric therapy should be directed against both aerobic and anaerobic bacteria 3.
- Pus, aspirated from a suppurative parotic abscess, should be plated on media that are supportive for the growth of aerobic and anaerobic bacteria, mycobacteria, and fungi 3.
Management of Specific Cases
- In cases of viral parotitis, such as mumps, treatment may involve supportive care and management of symptoms 4, 5.
- In cases of bacterial parotitis, treatment may involve antibiotic therapy and surgical drainage if necessary 2, 3, 6.
- A comprehensive patient-centered approach may be necessary to treat parotitis, taking into account the patient's overlapping clinical conditions, lifestyle, and work factors 6.
Prevention
- Maintenance of good oral hygiene, adequate hydration, and early and proper therapy of bacterial infection of the oropharynx may reduce the occurrence of suppurative parotitis 2.
- Predisposing factors to suppurative infections, such as dehydration, malnutrition, oral neoplasms, immunosuppuration, sialolithiasis, and medications that diminish salivation, should be addressed to prevent parotitis 3.