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(Fix missing context parameters for Cephalexin, Amoxicillin/Clavulanate, Azithromycin)
 
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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
''Treatment directed at [[S. aureus]] and [[Strep]] and [[E. coli]]''
**ADD [[TMP/SMX]] 2DS tabs PO q12hrs daily if suspect [[MRSA]]
*Uncomplicated mastitis → 10 days of antibiotics (regardless of [[MRSA]] suspicion)<ref>Levine BL. 2011 EMRA Antibiotic Guide. EMRA. Pg 78.</ref>
*[[Amoxicillin/Clavulanate]] 875mg PO q12hrs daily OR
*{{AntibioticDose|disease=Mastitis|drug=Dicloxacillin|dose=500mg PO q6hrs|context=First line if breastfeeding given safety for infant}} '''OR'''
*[[Dicloxacillin]] 500mg PO q6hrs daily
*{{AntibioticDose|disease=Mastitis|drug=Cephalexin|dose=500mg PO q6hrs|context=First line alternative}} '''OR'''
*[[Azithromycin]] 500mg PO once daily x 1 day then 250mg PO daily for days 2-5 OR
**Add [[TMP/SMX]] 2DS tabs PO q12hrs if suspect [[MRSA]]
*[[Clindamycin]] 450mg PO q8hrs if suspect [[MRSA]] OR
*{{AntibioticDose|disease=Mastitis|drug=Clindamycin|dose=450mg PO q8hrs|context=Also provides MRSA coverage}} '''OR'''
*{{AntibioticDose|disease=Mastitis|drug=Amoxicillin/Clavulanate|dose=875mg PO q12hrs|context=Alternative}} '''OR'''
*{{AntibioticDose|disease=Mastitis|drug=Azithromycin|dose=500mg PO x1 day 1, then 250mg PO daily days 2-5|context=PCN allergy alternative}}

Revisión actual - 11:23 20 mar 2026

  • 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

  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.
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