From the FDA Drug Label
DOSAGE AND ADMINISTRATION A small amount of mupirocin ointment should be applied to the affected area three times daily. The area treated may be covered with a gauze dressing if desired. Patients not showing a clinical response within 3 to 5 days should be re-evaluated. The FDA drug label does not answer the question.
From the Research
For folliculitis treatment while breastfeeding, topical treatments are generally preferred as first-line therapy, with warm compresses and gentle cleansing using antibacterial soap, and topical antibiotics such as clindamycin 1% or mupirocin 2% considered safe. The treatment approach should prioritize minimizing the risk of adverse effects to the nursing infant while effectively managing the maternal infection. According to the most recent and highest quality study available 1, which assessed various interventions for bacterial folliculitis and boils, there is uncertainty regarding the differences in efficacy and safety among various oral antibiotics, but topical treatments are generally recommended as the initial approach. Key considerations include:
- Warm compresses applied to affected areas 3-4 times daily for 15-20 minutes to reduce inflammation and promote drainage.
- Gentle cleansing with antibacterial soap like chlorhexidine wash or benzoyl peroxide 5% wash once or twice daily.
- For mild cases, topical antibiotics such as clindamycin 1% or mupirocin 2% applied twice daily for 7-10 days are considered safe while breastfeeding.
- If the condition is more severe or widespread, oral antibiotics like cephalexin (500mg four times daily for 7-10 days) or dicloxacillin (500mg four times daily for 7-10 days) are generally compatible with breastfeeding, but it's crucial to avoid using tetracyclines (doxycycline, minocycline) due to their potential to affect bone development in infants. Other studies, such as 2, 3, 4, and 5, provide additional insights into the management of folliculitis and related conditions, but the primary focus should remain on the safest and most effective treatments that can be used during breastfeeding, as guided by the most recent evidence 1. The goal is to effectively treat the maternal infection while ensuring the safety of the nursing infant, and the chosen treatment should reflect this balance, prioritizing topical therapies and selecting oral antibiotics judiciously when necessary.