From the Research
Acute segmental mastitis should be treated with a 1- to 2-day trial of conservative measures, including nonsteroidal anti-inflammatory drugs, ice application, and continued breastfeeding, before considering narrow-spectrum antibiotics. This approach is supported by the most recent and highest quality study 1, which suggests that most cases of mastitis are caused by inflammation and not a true infection. The study recommends a trial of conservative measures before prescribing antibiotics, and highlights the importance of proper lactation technique and breastfeeding support in preventing and managing mastitis.
Key points to consider in the management of acute segmental mastitis include:
- The importance of continued breastfeeding or pumping from the affected breast to prevent abscess formation and promote healing 2, 3
- The use of supportive measures such as warm compresses, over-the-counter pain relievers, and adequate rest and hydration to manage symptoms 2, 4
- The need for prompt evaluation and treatment to prevent complications like abscess formation or recurrent infections 5, 4
- The importance of reassurance, emotional support, and education for ongoing breastfeeding 4
It is also important to note that the choice of antibiotic therapy should be guided by milk cultures and susceptibility testing, and that narrow-spectrum antibiotics such as dicloxacillin or cephalexin may be effective in treating mastitis caused by Staphylococcus or Streptococcus 2, 1. However, the most recent study 1 suggests that antibiotics may not always be necessary, and that a trial of conservative measures should be considered first.