Antimicrobial prescribing: NHS Lothian
- Swab of parotid duct site for bacterial culture.
- Blood cultures if febrile.
- Consider mumps - send a viral swab of parotid duct/cheek for Mumps PCR.
Parotitis
- Most cases of bacterial parotitis are in frail elderly patients with dehydration.
- Consider mumps.
- Consider non-infective causes.
- Patients with a persistent (>2 weeks) symptoms or unexplained parotid swelling or suspected parotid duct calculi should be referred to ENT.
Recommended total duration: 7 days
| Oral route available and no signs of sepsis | Signs of sepsis | |
| Antimicrobial recommendation | Flucloxacillin 500mg every 6 hours orally PLUS Metronidazole 400mg every 8 hours orally | Flucloxacillin 2g every 6 hours IV PLUS Metronidazole 400mg every 8 hours orally |
| Penicillin Allergy/previous MRSA | Doxycycline 100mg every 12 hours orally PLUS Metronidazole 400mg every 8 hours orally | Vancomycin (use NHS Lothian Calculator located AMT intranet page) choose trough 10-15mg/L PLUS Metronidazole 400mg every 8 hours orally |
| Antimicrobial recommendation | Flucloxacillin 500mg every 6 hours orally PLUS Metronidazole 400mg every 8 hours orally |
| Penicillin Allergy/previous MRSA | Doxycycline 100mg every 12 hours orally PLUS Metronidazole 400mg every 8 hours orally |
Likely organisms: Staphylococcus aureus, anaerobes.