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
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