Management of Parotitis with Antimicrobial Therapy and Supportive Care

Initial Management Approach

The British Journal of Dermatology recommends using anti-inflammatory oral rinses or sprays containing benzydamine hydrochloride every 3 hours, particularly before eating, for pain management in patients with parotitis 1, 2
For inadequate pain control, topical anesthetic preparations such as viscous lidocaine 2% can be used, as suggested by the British Journal of Dermatology 1, 2
Systemic analgesics following the WHO pain management ladder may be provided to treat pain from inflammation, according to the Annals of Oncology 3

The British Journal of Dermatology suggests cleaning the mouth daily with warm saline mouthwashes to reduce bacterial colonization in patients with parotitis 1, 2
Using an antiseptic oral rinse twice daily, such as 0.2% chlorhexidine digluconate mouthwash or 1.5% hydrogen peroxide mouthwash, is recommended by the British Journal of Dermatology for patients with parotitis 1, 2
Protecting ulcerated mucosal surfaces with a mucoprotectant mouthwash three times a day, such as Gelclair, is suggested by the British Journal of Dermatology for patients with parotitis 1, 2
Applying white soft paraffin ointment to the lips if affected is recommended by the British Journal of Dermatology for patients with parotitis 1, 2

For patients with candidal infection, treatment with nystatin oral suspension or miconazole oral gel may be necessary, as suggested by the British Journal of Dermatology 1, 2

The World Health Organization recommends systemic analgesics following the WHO pain management ladder for more severe pain, and considers topical NSAIDs (e.g., amlexanox 5% oral paste) for moderate pain 4