Post-partum
- Encourage milk flow from affected breast either through breast feeding or breast pump.
- Risk factors for abscess formation:
maternal age > 30 years
gestational age > 41 weeks
history of mastitis
- Can continue breast-feeding while on therapy.
- Consider ultrasound if no response after one course of antibiotics.
Usual Pathogens
S. aureus
Minimal symptoms
| Empiric Therapy | Duration | |
|---|---|---|
| Hot compresses |
Mild
| Empiric Therapy | Duration | |
|---|---|---|
| Cloxacillin | 500mg PO qid | 7-10 days |
| or | ||
| Cephalexin | 500-1000mg PO qid | 7-10 days |
Penicillin and cephalexin allergy
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Cefuroxime axetil | 500mg PO bid | 7-10 days |
Cefuroxime allergy/MRSA
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Clindamycin | 300mg PO qid | 7-10 days |
Moderate-severe
| Empiric Therapy | Duration | |
|---|---|---|
| Cloxacillin | 2g IV q6h | 7-10 days |
| or | ||
| Cefazolin | 2g IV q8h | 7-10 days |
Penicillin and cefazolin allergy
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Ceftriaxone | 2g IV daily | 7-10 days |
Ceftriaxone allergy/MRSA
| Empiric Therapy | Duration | |
|---|---|---|
| Vancomycin | 15mg/kg IV q12h | 7-10 days |