From the Guidelines
Antibiotics (abx) should be used for mastitis when there is evidence of bacterial infection, such as purulent discharge, fever, or significant erythema and swelling.
Key Considerations
- The provided evidence does not directly address the treatment of mastitis with antibiotics 1.
- However, based on general medical knowledge, antibiotics such as dicloxacillin or cephalexin are commonly recommended for the treatment of mastitis.
- The dosage and duration of antibiotic treatment may vary depending on the severity of the infection and the patient's overall health.
Treatment Options
- A 10- to 14-day course of dicloxacillin (500 mg orally every 6 hours) or cephalexin (500 mg orally every 6 hours) is often recommended for patients with mastitis [(1) is not directly relevant, but based on general medical knowledge].
- For patients with penicillin allergy, a 10- to 14-day course of clindamycin (300 mg orally every 6 hours) or trimethoprim-sulfamethoxazole (160/800 mg orally every 12 hours) may be used.
Important Notes
- It is essential to note that the provided evidence 1 does not directly address the treatment of mastitis, and the recommended treatment options are based on general medical knowledge.
- The accuracy of antibiotic dosing, especially in children, can be improved with the use of devices such as the Broselow or Mercy TAPE 1.
From the Research
Antibiotic Use in Mastitis
- Antibiotics should be used to treat mastitis when the causative agent is a bacterial pathogen, such as Staphylococcus aureus, Staphylococcus epidermidis, or Corynebacterium spp. 2, 3, 4
- The choice of antibiotic should be based on the results of microbiological tests, such as culture and sensitivity testing, to ensure that the selected antibiotic is effective against the causative agent 3, 4
- In some cases, antibiotics such as amoxicillin and cephradine may be effective in treating mastitis, with no significant differences in cure rate or recurrence rate between the two 3
- However, the increasing incidence of antibiotic resistance is a concern, and alternative treatments such as probiotics and bacteriocins may be considered 2
Specific Antibiotic Regimens
- Dicloxacillin, a beta-lactam antibiotic, has been shown to have limited transfer into human milk, with a relative infant dose of 0.03% 5
- Clarithromycin, a lipophilic antibiotic, has been used as a first-line treatment for granulomatous mastitis, with a mean duration of therapy of 7.0 months 4
- Combination therapy with drugs that work synergistically against conserved and unique targets may help increase efficacy and lower the usage of antibiotics for treating bacterial infections 6
Treatment Duration and Outcomes
- The duration of antibiotic therapy for mastitis can vary, with a mean duration of 7.0 months reported in one study 4
- The average time from the first breast clinic visit to clinical resolution of granulomatous mastitis was 8.0 months, with some patients requiring adjunctive therapy with prednisone or surgery 4