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mastitis

mastitis

introduction

  • mastitis is a common complication of lactation in the post partum period and is usually caused by Staphylococcus aureus.
  • see the above fact sheet for its prevention and early Mx.

ED Mx of established puerperal mastitis

  • maintain adequate fluid intake
  • continue breast feeding:
    • the milk is safe for the baby.
    • it is important to continue to breastfeed or express from the affected breast.
    • if the breast is not well drained, symptoms may worsen and the milk supply may drop in this breast.
  • look for and exclude presence of breast abscess which may require surgical drainage
    • consider diagnostic ultrasound if suspect abscess formation
  • mild cases can be Rx with oral flucloxacillin 500mg qid
  • more severe cases or non-responsive cases often require admission under the obstetrics unit and iv flucloxacillin
  • monitor hepatic function if flucloxacillin treatment continues for > 2 weeks, especially if there are other risk factors.
  • if allergic to penicillin consider oral cephalexin 500mg qid or cephazolin 1g iv tds
  • if history of immediate penicillins allergy, consider clindamycin 450mg qid o for 5 days or 450mg tds iv, or vancomycin 1g bd iv if pathogen sensitivity is confirmed.
mastitis.txt · Last modified: 2012/01/10 23:27 by 127.0.0.1

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