Maintenance of adequate hydration and administration of parenteral antimicrobial therapy are essential. The choice of antibiotics depends on the etiologic agent. Most cases respond to antimicrobial therapy; however, some inflamed glands may reach a stage of abscess formation that requires surgical drainage. Broad antimicrobial therapy is indicated to cover all possible aerobic and anaerobic pathogens, including adequate coverage for S. aureus, GABHS, and beta-lactamase-producing AGNB. The presence of methicillin-resistant staphylococci may mandate the use of vancomycin or linezolid. Clindamycin, cefoxitin, a carbapenem (i.e. imipenem, meropenem), tigecycline, the combination of metronidazole and a macrolide, or a penicillin plus beta-lactamase inhibitor, provide adequate coverage for anaerobic as well as aerobic bacteria.
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.
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