Sialolithiasis medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Medical Therapy
Conservative treatment
Conservative treatment is the first line of therapy in the most patients. The most commonly used treatment options are:
- Hydration
- Apply moist heat
- Massage the gland
- Duct milking
- Using agents that increase the salivar flow, such as lemon drops.
- Discontinue of the medication that decrease the saliva flow, such as the TCAs because of their anticholinergic effects.
- Pain control with NSAIDs, or opoid analgesics, if needed.
- Antibiotics usage in the case of superimposed infection :
- Preferred regimen(1): Dicloxacillin 500 mg q 6h PO for 7 to 10 days.
- Preferred regimen(2): Cephalexin 500 mg q 6h PO for 7 to 10 days.
- If the patients clinics did not change in five days of using above antibiotics, change to:
- Preferred regimen(1): Amoxicillin/clavulanate 625 mg q 8h PO for 7 to 10 days.
- Preferred regimen(2): Clindamycin 300 mg q 8h PO for 7 to 10 days.
- Duct discharge should be used for culture.