From the Guidelines
Antibiotics (abx) should be used for mastitis when symptoms are severe, or when there is no improvement within 12-24 hours of supportive care, or if Staphylococcus aureus or other bacteria are suspected or confirmed 1.
Key Considerations
- The choice of antibiotic should be based on the severity of the infection and the suspected or confirmed causative organism 1.
- For mild infections, amoxicillin-clavulanic acid, cloxacillin, or cefalexin may be suitable options 1.
- For more severe infections, such as those caused by methicillin-resistant Staphylococcus aureus (MRSA), vancomycin, linezolid, or clindamycin may be necessary 1.
Treatment Duration and Dosing
- The duration of antibiotic treatment for mastitis is typically 10-14 days 1.
- The dose and frequency of the antibiotic will depend on the specific medication and the severity of the infection, but examples include 250-500 mg every 6 hours for dicloxacillin or cephalexin 1.
Important Notes
- It is essential to note that antibiotics should only be used when necessary, as overuse can contribute to antibiotic resistance 1.
- Supportive care, such as rest, hydration, and pain management, should always be provided in conjunction with antibiotic treatment for mastitis 1.
From the Research
Use of Antibiotics for Mastitis
- Antibiotics are commonly used to prevent or treat mastitis infections in dairy cattle, but the increased incidence of antibiotic resistance is a key cause of concern for treatment of the disease 2, 3.
- Studies have shown that critically important antimicrobials are generally not needed to treat nonsevere clinical mastitis in lactating dairy cows, and that non-critically important antimicrobials have comparable efficacy to treat nonsevere bovine clinical mastitis caused by the most commonly reported bacteria 4.
- Alternative treatments, such as phage therapy, have been proposed as a viable option for the control of Staphylococcus aureus intramammary infections, which are refractory to antibiotic treatment and frequently result in chronic mastitis 5.
- Anti-virulence compounds that target virulence factors of Staphylococcus aureus, rather than cell viability, have also been proposed as a new therapeutic option for the treatment of bovine mastitis, with the potential to reduce the selective pressure towards the development of resistance and minimize the impact on the host commensal microbiota 6.
Conditions for Antibiotic Use
- Antibiotics may be necessary for the treatment of severe clinical mastitis, but their use should be judicious and based on a thorough diagnosis of the causative pathogen and its antimicrobial susceptibility profile.
- The use of antibiotics for the treatment of nonsevere clinical mastitis should be avoided, especially when the causative pathogen is susceptible to non-critically important antimicrobials.
- Alternative treatments, such as phage therapy or anti-virulence compounds, should be considered for the treatment of mastitis caused by antibiotic-resistant pathogens or in cases where antibiotic use is not justified.