From the Research
Mastitis should be treated with antibiotics that are effective against Staphylococcus aureus, such as dicloxacillin or cephalexin, for 7-10 days to reduce morbidity and mortality, and improve quality of life. When considering the treatment of mastitis, it is essential to prioritize antibiotics that target the most common pathogens, including Staphylococcus aureus and Streptococcus species 1. The treatment approach should include:
- Antibiotics, such as dicloxacillin or cephalexin, 500 mg orally four times daily for 7-10 days, as first-line therapy
- Alternative antibiotics, like clindamycin 300 mg orally four times daily, for patients with penicillin allergies
- Broader-spectrum antibiotics, such as amoxicillin-clavulanate 875/125 mg twice daily, for more severe cases or those unresponsive to initial treatment
- Supportive measures, including continued breastfeeding or expressing milk from the affected breast, applying warm compresses, ensuring proper latch technique, and taking anti-inflammatory medications like ibuprofen 400-600 mg every 6 hours as needed for pain and inflammation 2. It is also crucial to be aware of the increasing incidence of methicillin-resistant Staphylococcus aureus (MRSA) in mastitis cases, and to adjust treatment accordingly 3. However, the most recent and highest quality study 1 recommends dicloxacillin or cephalexin as the preferred treatment, and this should be the primary approach. Key considerations in mastitis treatment include:
- Reducing the risk of mastitis through frequent, complete emptying of the breast and optimizing breastfeeding technique
- Encouraging continued breastfeeding in the presence of mastitis, as it does not pose a risk to the infant and can help prevent milk stasis
- Monitoring for complications, such as breast abscess, and seeking medical attention if symptoms worsen or do not improve with treatment.