treatment

Last reviewed 01/2018

• parotitis prophylaxis is important the principles are:

  • adequate fluid intake
  • avoidance of anti-cholinergics
  • good oral hygiene, i.e. frequent gargles, mouth irrigation, other mouth cleansing and moistening measures
  • stimulation of salivary flow by chewing gum may be of benefit
    
    
• in acute suppurative parotitis the treatment consists of:
  • stringent oral hygiene
  • key in the treatment of acute suppurative parotitis (ASP) is rehydration (may require intravenous fluids)
  • most cases of ASP due to Staphylococcal aureus, the first drug of choice should be an initial empirical treatment with an antistaphlylococcal penicillin e.g. flucloxacillin, co-amoxiclav. Antibiotic treatment is continued for 10 to 14 days
  • if there is failure of medical management then surgery should be considered
    • surgical intervention e.g. incision and drainage of the gland, may be indicated if:
      • lack of improvement after 3 to 5 days of antibiotic therapy,
      • facial nerve involvement,
      • involvement of adjacent vital structures (lateral pharyngeal space, deep fascial spaces),
      • frank abscess formation within the gland parenchyma
  • also there is support for surgical intervention in the form of superficial parotidectomy for patients with ASP in whom chronic recurrent parotitis then develops

Reference:

1. Fatahhi TT et al. Management of acute suppurative parotitis. J Oral Maxillofac Surg. 2002 Apr;60(4):446-8.