There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
From the Research
Antibiotic Treatment for Mastitis
The appropriate antibiotic treatment for mastitis is not well established due to insufficient evidence from high-quality studies 1, 2, 3. However, some studies suggest that narrow-spectrum antibiotics may be prescribed to cover common skin flora, such as Staphylococcus and Streptococcus, if conservative measures are not effective 4.
Causes and Risk Factors
Mastitis can be caused by ineffective positioning of the baby at the breast or restricted feeding, and is commonly caused by Staphylococcus aureus 1, 2, 3. Factors that increase the risk of mastitis include overstimulation of milk production and tissue trauma from aggressive breast massage 4.
Treatment Approaches
- Conservative measures, such as nonsteroidal anti-inflammatory drugs, ice application, and feeding the infant directly from the breast, may be sufficient for treatment in some cases 4.
- Antibiotic therapy may be considered if there is no improvement in symptoms, especially if milk cultures indicate a bacterial infection 4.
- Culture-based therapy and severity levels are key to management of clinical mastitis, with antibiotic therapy strongly considered for gram-positive clinical mastitis 5.