Mastitis

O91.2

• Description
• General measures
• Medicine treatment
• Referral

DESCRIPTION

Inflammation of the breast tissue surrounding the milk ducts.
Risk factor includes retrograde infection from a fissured nipple and milk stasis. Commonly isolated pathogens include S. aureus and S. epidermidis . Presentation includes painful breast(s), fever, erythema and malaise.

GENERAL MEASURES

Compresses.
Regular expressing of breast milk.
Do not stop breastfeeding, unless a breast abscess has developed.
If breast abscess present, refer for incision and drainage.

MEDICINE TREATMENT

• Flucloxacillin, oral, 500mg 6hourly for 5 days.

Severe penicillin allergy: (Z88.0)

• Macrolide, e.g.:
  • Azithromycin, oral, 500mg daily for 3 days.
• Pain:
  • Paracetamol, oral, 1 g 4–6 hourly when required.
    • Maximum dose: 15 mg/kg/dose.
    • Maximum dose: 4g in 24 hours.

REFERRAL

• Breast abscess.
• No improvement after 2 days.