From the Guidelines
Antibiotics are recommended for the treatment of mastitis when symptoms persist or worsen after 12-24 hours of supportive care, or if there is evidence of a bacterial infection, such as Staphylococcus aureus or Streptococcus species 1.
Key Considerations
- For lactational mastitis, a 10-14 day course of dicloxacillin (500mg orally every 6 hours) or cephalexin (500mg orally every 6 hours) is typically prescribed 1.
- For non-lactational mastitis, a 7-10 day course of ciprofloxacin (500mg orally every 12 hours) or amoxicillin-clavulanate (875mg/125mg orally every 12 hours) may be used 1.
- In severe cases, hospitalization and intravenous antibiotics, such as oxacillin (1-2g every 4-6 hours) or vancomycin (1g every 12 hours), may be necessary 1.
Important Factors
- The decision to administer antibiotics should be based on the presence or absence of systemic inflammatory response syndrome (SIRS), such as temperature >38°C or <36°C, tachypnea >24 breaths per minute, tachycardia >90 beats per minute, or white blood cell count >12 000 or <400 cells/µL 1.
- Antibiotics active against MRSA are recommended for patients with carbuncles or abscesses who have failed initial antibiotic treatment or have markedly impaired host defenses or in patients with SIRS and hypotension 1.
- Clindamycin, linezolid, and daptomycin are alternative options for the treatment of MRSA infections 1.