From the FDA Drug Label
Duration of therapy varies with the type and severity of infection as well as the overall condition of the patient, therefore, it should be determined by the clinical and bacteriological response of the patient In severe staphylococcal infections, therapy with penicillinase-resistant penicillins should be continued for at least 14 days. Therapy should be continued for at least 48 hours after the patient has become afebrile, asymptomatic, and cultures are negative.
The treatment for mastitis with moderate to severe symptoms should be determined by the clinical and bacteriological response of the patient.
- Key considerations:
- Therapy with penicillinase-resistant penicillins, such as dicloxacillin, should be continued for at least 14 days in severe infections.
- Treatment should be continued for at least 48 hours after the patient has become afebrile, asymptomatic, and cultures are negative. 1
From the Research
Treatment for mastitis with moderate to severe symptoms should always be initiated promptly, typically with antibiotics, to prevent complications and support the continuation of breastfeeding. When considering treatment, it's essential to prioritize the most recent and highest quality evidence available. According to the most recent study 2, mastitis is an inflammation in the breast that may involve a bacterial infection, and without proper treatment, it can lead to the cessation of breastfeeding and the development of an abscess.
Key Considerations for Treatment
- The choice of antibiotic should be effective against Staphylococcus aureus, a common cause of mastitis, with options including dicloxacillin or cephalexin 3.
- For penicillin-allergic patients, alternatives such as clindamycin may be considered 3.
- Supportive measures, including continued breastfeeding or expressing milk from the affected breast, applying warm compresses, and taking pain medication like ibuprofen or acetaminophen, are also crucial 2.
- It's vital to monitor symptoms and seek immediate medical attention if they do not improve within 48 hours of antibiotic therapy, if fever persists, or if an abscess is suspected 2.
Recent Findings and Recommendations
- A study from 2020 2 emphasizes the importance of proper treatment and supportive therapy in mastitis to prevent complications and ensure the continuation of breastfeeding.
- Another study from 2018 4 highlights the microbiology of mastitis, identifying Staphylococcus aureus, Staphylococcus epidermidis, and corynebacteria as common pathogens, and discusses the potential of probiotics and bacteriocins as alternative treatments.
- However, the most recent and highest quality evidence should guide treatment decisions, prioritizing the use of antibiotics effective against the most common causative organisms 2.