Mastitis - Antibiotic Prescribing

Comment from expert advisory group

• Note higher and more frequent 6-hourly doses of antibiotics are required in mastitis treatment to ensure adequate tissue penetration.
• Low dose i.e., 250mg or 8-hourly dosing may result in treatment failure.
• Duration of treatment required can vary from 5 to 10 days.
• Patients should be reassessed after 5 days as treatment failures do occur and referral to hospital may be necessary if not responding to treatment. If improving but not fully resolved, extend treatment course.
• The patient should be encouraged to either breastfeed or express to ensure milk stasis does not occur. Cold compresses and analgesia should be used

Treatment

Patient Information

• Visit HSE My Child website for further information further information on Mastitis while breast feeding
• An information sheet on ‘Antibiotics and breastfeeding' is available from the Breastfeeding Network UK
• Further information on Antibiotics and Breast-feeding can be found on the Mother to Baby website (USA) (Search or Use Browse by Medications category).
• Visit HPSC Information Leaflets pages for the General Public, (MRSA, CRE, etc)

Safe Prescribing (visit the safe prescribing page)

• Doses are oral and for adults unless otherwise stated
• Dosing in children quick reference dosage/weight guide
• Penicillin allergy – tips on prescribing in penicillin allergy
• Renal impairment dosing table
• Drug interactions table. Extensive drug interactions for clarithromycin, fluoroquinolones, azole antifungals and rifampicin. Many antibiotics increase the risk of bleeding with anticoagulants
• Visit the Health Products Regulatory Authority (HPRA) website for detailed drug information (summary of product characteristics and patient information leaflets). Dosing details, contraindications and drug interactions can also be found in the Irish Medicines Formulary (IMF) or other reference sources such as British National Formulary (BNF) / BNF for children (BNFC).

Reviewed Jan 2021