Parotitis medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S. Faizan Sheraz, M.D. [2]
Overview
Parotitis therapy is primarily supportive and symptomatic. Common therapies include analgesics, such as paracetemol and diclofenac, and other measures to relieve pain, including heat massages and warm saltwater mouth rinses. Therapy that increases saliva flow is also used, including extra fluids and foods that stimulate saliva flow, including lemon drops and vitamin C lozenges. Other therapies are used to target the potential cause of the parotitis, including antiretroviral medication, antimicrobial therapy, anti-tuberculosis therapy, and sialendoscopy and parotid gland surgery.
Medical Therapy
Viral Parotitis[1]
- Viral parotitis treatment is primarily symptomatic and supportive, including the following:[2]
- Analgesics:[3]
- Massaging the parotid gland with heat.
- Rinsing the mouth with warm salt water.
- Increasing saliva flow with extra fluids or foods that stimulate saliva flow:
- Viral parotitis from HIV should also be treated with antiretroviral medication .
Recurrent Parotitis[4]
In addition to supportive care, chronic recurrent parotitis treatment includes the following:
- Sialendoscopy: Used to relieve parotitis in patients with parotid gland obstruction
- Surgical removal of the parotid gland if the cause is neoplasmic or symptomatic treatment does not work.
Bacterial Parotitis
- Antibiotic therapy is used to treat parotitis resulting from Staphylococcus aureus infection, depending on whether the strain is suspected to be methicillin-susceptible Staphylococcus aureus (MSSA) or methicillin-resistant Staphylococcus aureus (MRSA).[5]
- Preferred regimen (MSSA suspected): Nafcillin 2 g IV q4h OR Oxacillin 2 g IV q4h
- Preferred regimen (MRSA suspected): Vancomycin 1 g IV q12h
- If an abscess forms then surgical drainage will be required.[6]
- Parotitis from extrapulmonary tuberculosis will require anti-tuberculosis therapy:[7]
References
- ↑ "Salivary gland infections: MedlinePlus Medical Encyclopedia".
- ↑ Gupta, R. K (2005). "Mumps and the UK epidemic 2005". BMJ. 330 (7500): 1132–1135. doi:10.1136/bmj.330.7500.1132. ISSN 0959-8138.
- ↑ Sujatha S, Rakesh N, Raghav N, Devaraju D, Shridevi G (2009). "Case report: Report of a rare case of juvenile recurrent parotitis and review of literature". Eur Arch Paediatr Dent. 10 Suppl 1: 31–4. PMID 19863896.
- ↑ 4.0 4.1 Wilson KF, Meier JD, Ward PD (2014). "Salivary gland disorders". Am Fam Physician. 89 (11): 882–8. PMID 25077394.
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
- ↑ Brook I (2003). "Acute bacterial suppurative parotitis: microbiology and management". J Craniofac Surg. 14 (1): 37–40. PMID 12544218.
- ↑ "CDC | TB | Treatment".