The same recommendation was also made by another user on June 7, 2024
@Ahmed7 Is it possible to confirm this information and update this note as well as the related notes 1583369860857 and 1583370463526 as soon as possible? The new answers are significantly different than the originals and AMBOSS has a question with this new information as the correct answer
Hi, so sorry for the delay. Can you take a screenshot of the question from AMBOSS if possible please?
Thank you, will keep on my to do list!
Will need to double check with uworld medical library so I don’t see a uworld step 2 QID for this card, but just @’ing for now to keep on the radar: @AnKing-Maintainers
Couldn’t find it on UW library.
AMBOSS library says:
- Treatment [5]
- Symptomatic management of salivary gland disorders, e.g.:
- Sialagogues
- NSAIDs
- Antibiotic therapy
- Amoxicillin/clavulanate; OR clindamycin
- Surgery
- Symptomatic management of salivary gland disorders, e.g.:
I’ve attached a screenshot of the AMBOSS library information that shows the different antibiotic therapy based on the patient’s ability to tolerate oral intake or the severity of the infection
Oh my bad. I was in high yield mode. Thanks for the Screenshot.
Here’s an article from PMC for the records @/Ahmed7
https://pmc.ncbi.nlm.nih.gov/articles/PMC10426371/?hl=en-US
“In the outpatient setting, a combination of 875 mg of amoxicillin and 125 mg of clavulanate orally twice a day will provide adequate coverage. If no improvement is seen or the patient’s condition worsens, the patient will require treatment in an inpatient setting where a combination of 2 g of ampicillin and 1 g of sulbactam intravenously every 6 hours is the recommended first-line treatment. Given the absence of established guidelines, duration of treatment is based on the severity of the infection and its response to therapy.”
Any idea where the original came from? Apparently it’s been this way since at least the beginning is AnkiHub. 
I’m not sure, but can we update the cards since this is the information AMBOSS is using and they have a question using the same information as well?
@dwhy00 We need to also consider other resources, we cannot make changes based on just one resource, for example, if a question on a NBME form or UWorld or another resource says something else. This is why it may take some time to consider, review, and push these changes
I think it is too low yield to be even discussed, I went through NBME sources:
IM CMS form 7, Q 28
NBME 10 block 2, Q 23
NBME 12 block 2, Q 03
NBME 16 block 4, Q 19
None of them mentioned what antibiotics, just that, antibiotics should cover Staph aureus.
Considering that, and the NLM paper, and AMBOSS article, I think we can push it.
Funny thing is that the source of this card is the MedicalArk deck note, that itself was based on AMBOSS IM section. Probably like 4-5 years ago.
Related notes 1583369860857 and 1583370463526, if we push it.
Also to add, all the antibiotics are off-label
AMBOSS clinical mode:
UpToDate article:
Suppurative parotitis in adults.pdf (133.3 KB)
“In immunocompetent patients with a community-acquired infection, we suggest ampicillin-sulbactam (3 g IV every six hours). Alternative regimens are outlined in the table (table 1). If the patient is known to be colonized with MRSA or has risk factors for MRSA (table 2), we also add one of the following: vancomycin (table 3) or linezolid (600 mg orally or IV every 12 hours) or daptomycin (6 mg/kg IV every 24 hours). Oral step-down regimens — Once the patient has improved (afebrile, reduced pain and swelling), the initial parenteral regimen can be transitioned to an oral regimen. If cultures have not been obtained, empiric oral regimens should include the same spectrum of pathogens as initial parenteral regimens (eg, staphylococci, H. influenzae, and oral aerobes and anaerobes). If microbiologic data are available and identify pathogens not treated by the initial regimen, the oral regimen should be broadened to include them; however, we continue to treat oral aerobes and anaerobes, even if these are not isolated. If MRSA does not grow on culture, treatment against MRSA can be discontinued. We prefer amoxicillin-clavulanate (875/125 mg orally twice daily) for oral-step down of community-acquired infection; alternative oral regimens are outlined in the table (table 1) [37,38]. If therapy against MRSA is indicated, we add one of the following: linezolid (600 mg orally twice daily) or trimethoprim-sulfamethoxazole (1 double-strength tablet orally every 12 hours).”
I support this change. I also think we should try to cut dow some of the text on this card. The extra section is is way too long.
Know it’s not authoritative for the deck, for what it’s worth I utilize Dynamed a lot as well which also supports empiric therapy with amoxicillin/clavulanate, ampicillin/sulbactam, cefoxitin, clindamycin, or ertapenem.
If any push is made would also need to update nid:1583369860857