Template:Mastitis antibiotics: Difference between revisions

Latest revision as of 17:51, 14 May 2019

No need to routinely interrupt breastfeeding with puerperal mastitis.
For mild symptoms <24 hours, supportive care may be sufficient^[1]
- Effective milk removal (frequent breast feeding - use pumping to augment milk removal)
- Analgesia (NSAIDs)

Treatment directed at S. aureus and Strep and E. coli

Uncomplicated mastitis → 10 days of antibiotics (regardless of MRSA suspicion)^[2]
Dicloxacillin 500mg PO q6hrs, considered first line if breastfeeding given safety for infant OR
Cephalexin 500mg PO q6hrs OR
- Add TMP/SMX 2DS tabs PO q12hrs if suspect MRSA
Clindamycin 450mg PO q8hrs (also provides MRSA coverage) OR
Amoxicillin/Clavulanate 875mg PO q12hrs OR
Azithromycin 500mg PO x1 on day 1, then 250mg PO daily for days 2-5

↑ Amir LH. ABM Clinical Protocol #4: Mastitis, Revised March 2014. Breastfeeding Medicine. 2014;9(5):239-243. doi:10.1089/bfm.2014.9984.
↑ Levine BL. 2011 EMRA Antibiotic Guide. EMRA. Pg 78.

[Amir-1] Amir LH. ABM Clinical Protocol #4: Mastitis, Revised March 2014. Breastfeeding Medicine. 2014;9(5):239-243. doi:10.1089/bfm.2014.9984.

[2] Levine BL. 2011 EMRA Antibiotic Guide. EMRA. Pg 78.

[1]

[2]

@@ Line 1: / Line 1: @@
-There is no need to routinely interrupt breastfeeding with puerperal mastitis.  Encourage frequent breast emptying which in itself is therapeutic
+*No need to routinely interrupt breastfeeding with puerperal mastitis.
-===[[Antibiotics]]===
+*For mild symptoms <24 hours, supportive care may be sufficient<ref name="Amir">Amir LH. ABM Clinical Protocol #4: Mastitis, Revised March 2014. Breastfeeding Medicine. 2014;9(5):239-243. doi:10.1089/bfm.2014.9984.</ref>
-''Treatment directed at S. aureus and Strep and E. coli
+**Effective milk removal (frequent breast feeding - use pumping to augment milk removal)
-''For uncomplicated, 10 days abx regardless of MRSA suspicion<ref>Levine BL. 2011 EMRA Antibiotic Guide. EMRA. Pg 78.</ref>
+**Analgesia (NSAIDs)
-*[[Cephalexin]] 500mg PO q6hrs daily OR
-**ADD [[TMP/SMX]] 2DS tabs PO q12hrs daily if suspect [[MRSA]]
+''Treatment directed at [[S. aureus]] and [[Strep]] and [[E. coli]]''
-*[[Amoxicillin/Clavulanate]] 875mg PO q12hrs daily OR
+*Uncomplicated mastitis → 10 days of antibiotics (regardless of [[MRSA]] suspicion)<ref>Levine BL. 2011 EMRA Antibiotic Guide. EMRA. Pg 78.</ref>
-*[[Dicloxacillin]] 500mg PO q6hrs daily
+*[[Dicloxacillin]] 500mg PO q6hrs, considered first line if breastfeeding given safety for infant '''OR'''
-*[[Azithromycin]] 500mg PO once daily x 1 day then 250mg PO daily for days 2-5 OR
+*[[Cephalexin]] 500mg PO q6hrs '''OR'''
-*[[Clindamycin]] 450mg PO q8hrs if suspect [[MRSA]] OR
+**Add [[TMP/SMX]] 2DS tabs PO q12hrs if suspect [[MRSA]]
+*[[Clindamycin]] 450mg PO q8hrs (also provides MRSA coverage) '''OR'''
+*[[Amoxicillin/Clavulanate]] 875mg PO q12hrs '''OR'''
+*[[Azithromycin]] 500mg PO x1 on day 1, then 250mg PO daily for days 2-5