From the Guidelines
For mastitis treatment with Keflex (cephalexin), take 500 mg orally four times daily (every 6 hours) for 7-10 days, and continue to breastfeed or express milk frequently from the affected breast to prevent milk stasis and help clear the infection. While taking antibiotics, it is essential to complete the entire course even if symptoms improve quickly. The American Academy of Pediatrics recommends that mothers with mastitis continue to breastfeed, as regular feeding or expression of milk is an adjunct to other treatment 1. Applying warm compresses to the affected breast before feeding can improve milk flow and reduce pain. Over-the-counter pain relievers like ibuprofen or acetaminophen can be taken as needed for pain and inflammation. Staying well-hydrated and getting adequate rest is crucial to support recovery. Keflex is effective for mastitis because it targets the common bacteria that cause the infection, particularly Staphylococcus aureus, and is considered safe during breastfeeding 1. If symptoms don't improve within 48 hours, fever worsens, or you develop severe pain or redness, contact your healthcare provider as you may need a different antibiotic or additional treatment.
Some key points to consider:
- Breastfeeding can continue on the affected side as long as the infant’s mouth does not contact purulent material 1.
- Approximately 10% of mastitis cases progress to breast abscesses, which require drainage 1.
- The benefits of breastfeeding for both the mother and the infant are numerous, including a lower risk of various diseases and conditions, such as type 2 diabetes, hypertension, and certain types of cancer 1.
- It is essential to prioritize the health and well-being of both the mother and the infant when managing mastitis, and to seek medical attention if symptoms persist or worsen.
From the FDA Drug Label
PRECAUTIONS General Prolonged use of cephalexin may result in the overgrowth of nonsusceptible organisms. Indicated surgical procedures should be performed in conjunction with antibiotic therapy
The plan for mastitis taking Keflex (cefalexin) should include monitoring for signs of superinfection and careful observation to detect any side effects or unusual manifestations of drug idiosyncrasy.
- Prolonged use of cephalexin may lead to the overgrowth of nonsusceptible organisms, which should be considered when treating mastitis.
- Surgical procedures may be necessary in conjunction with antibiotic therapy, depending on the severity of the mastitis. 2
From the Research
Planning for Mastitis while taking Keflex
- Mastitis is a spectrum of inflammatory conditions, with lactational mastitis being the most common, affecting approximately 10% of women in the United States, usually within the first 3 months postpartum 3.
- Diagnosis is made clinically based on symptoms such as fever, malaise, focal breast tenderness, and overlying skin erythema or hyperpigmentation, without the need for laboratory tests or imaging 3.
- Treatment may involve a 1- to 2-day trial of conservative measures, including nonsteroidal anti-inflammatory drugs, ice application, and feeding the infant directly from the breast 3.
- If symptoms do not improve, narrow-spectrum antibiotics such as Keflex (cephalexin) may be prescribed to cover common skin flora, including Staphylococcus and Streptococcus 3, 4.
- However, there is insufficient evidence to confirm or refute the effectiveness of antibiotic therapy for the treatment of lactational mastitis, and high-quality studies are needed to determine the best course of treatment 4.
- Effective milk removal is a crucial part of treatment and may make antibiotics unnecessary, and culture of the milk is necessary to determine the infecting organism and its antibiotic sensitivity 5.
- In most cases, women with mastitis can continue to breast-feed from the affected breast during treatment, and the transfer of antibiotics such as dicloxacillin and cloxacillin to breast milk is minimal 5.