From the Guidelines
The primary treatment for a breast abscess is incision and drainage, which can be done through needle aspiration under ultrasound guidance for smaller abscesses or surgical incision and drainage for larger ones, as recommended by the most recent guidelines 1. The goal of treatment is to drain the abscess and prevent complications such as recurrent infections or extensive tissue damage.
- Incision and drainage is the primary treatment for breast abscesses, with antibiotics prescribed to treat the underlying infection.
- For patients with severe or extensive disease, associated comorbidities or immunosuppression, or lack of response to incision and drainage alone, antibiotic therapy is recommended 1.
- The choice of antibiotic should be based on the suspected or confirmed pathogen, with coverage for Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus (MRSA), as it is a common cause of breast abscesses 1.
- Pain management with acetaminophen or ibuprofen is also important, as well as continued breastfeeding or breast milk expression to prevent milk stasis and promote healing.
- Warm compresses applied to the affected area for 15-20 minutes several times daily can help improve blood circulation and reduce pain.
- It is essential to note that the treatment of breast abscesses should be individualized based on the patient's clinical response and the severity of the infection, as recommended by the most recent guidelines 1.
From the Research
Treatment Options for Breast Abscess
- The primary treatment for breast abscess includes antibiotics and drainage of the abscess 2, 3, 4, 5.
- Antibiotics such as clindamycin, ciprofloxacin, and vancomycin are often prescribed to treat breast abscesses caused by Staphylococcus aureus, including MRSA 2, 4, 5.
- Ultrasound-guided percutaneous drainage is a recommended treatment for breast abscesses, and the presence of MRSA may not adversely affect treatment outcomes 3.
- In cases of life-threatening septic shock, measures such as removal of necrotic tissue, continuous catheter irrigation and drainage, intravenous infusion of vancomycin, and fluid resuscitation may be necessary 4.
- For uncomplicated skin and soft-tissue abscesses caused by MRSA, minocycline may be a preferred treatment option over trimethoprim-sulfamethoxazole or doxycycline 6.
Antibiotic Resistance and Treatment
- The choice of empirical antibiotics for breast abscesses should be guided by institutional antibiograms and targeted treatment 2.
- First-line prescribed empirical antibiotics such as amoxicillin clavulanate may be resistant to MRSA, and alternative antibiotics such as clindamycin and ciprofloxacin may be preferred 2.
- Vancomycin is effective against MRSA and may be used in combination with clindamycin or linezolid to treat toxic shock syndrome secondary to breast abscess 5.
Drainage and Surgical Intervention
- Incision and drainage of the breast abscess is an important part of treatment, and may be performed surgically or percutaneously under ultrasound guidance 3, 4, 5.
- In cases of severe infection or life-threatening septic shock, surgical intervention may be necessary to remove necrotic tissue and drain the abscess 4.