Infectious Disease Compendium

Mastitis

Diagnosis

Infection of the breast.

Epidemiologic Risks

Breast feeding, alterations in duct drainage.

Microbiology

S. aureus and streptococci in the peripartum time, sub-nipple infection are often mixed anaerobic.

Acinomycosis may be a cause as well (PubMed).

Empiric Therapy

Peripartum: cephalexin OR dicloxacillin. If MRSA an issue and not breast feeding, tmp/sulfa (I give 2-3 ds po tid) or doxycycline.

Sub-nipple infections/abscess: amoxicillin/clavulanate OR clindamycin.

A recent study demonstrated that lactobacilli were equal to antibiotics, they did not have a placebo group and they did not report whether susceptabilty results made a difference in outcome, so it is so flawed I remain skeptical (PubMed). CID loves to call studies "Major Articles" but I am not certain they use the same definition of 'major' that I do.

Pearls

Rants