Suppurative parotitis (inc other salivary gland infection)
- If present, aspiration or surgical drainage of pus collection and sampling for microscopy and culture is recommended.
- Blood cultures should be taken, ideally before commencing antibiotic.
- Parotitis is typically cause by Staphylococcus aureus.
- Recommended antibiotic therapy listed below is empiric. Treatment should always be tailored to culture and sensitivity.
Treat for 7 days (review iv daily)
Preferred
flucloxacillin 1g po qds. For severe infection: flucloxacillin 1g iv qds (increase to 2g iv qds in obese patients)
For severe cases or immunocompromised patients: ADD gentamicin* 5mg/kg iv (Gentamicin is for maximum of 3 days).
*Take a gentamicin level at 6-14 hours after first dose to calculate dosing interval, usually 24 hourly, 36 hourly or 48 hourly. See gentamicin monograph for dosing (including renal dosing) and monitoring
Alternative
For penicillin allergy (non-severe)
cefalexin 1g po tds (or cefazolin 1g iv tds (increase to 2g iv tds for severe infection or in obese patients)
For severe cases or immunocompromised patients: ADD gentamicin* 5mg/kg iv (Gentamicin is for maximum of 3 days).
*Take a gentamicin level at 6-14 hours after first dose to calculate dosing interval, usually 24 hourly, 36 hourly or 48 hourly. See gentamicin monograph for dosing (including renal dosing) and monitoring
For penicillin allergy (severe) or MRSA positive patients
co-trimoxazole 960mg po bd (or iv if NBM)
For severe cases or immunocompromised patients: ADD gentamicin* 5mg/kg iv (Gentamicin is for maximum of 3 days).
*Take a gentamicin level at 6-14 hours after first dose to calculate dosing interval, usually 24 hourly, 36 hourly or 48 hourly. See gentamicin monograph for dosing (including renal dosing) and monitoring.
Additional Information
See Faculty of Dental Surgery Antimicrobial Prescribing in Dentistry Good Practice Guidelines