[Treatment of mastitis in general practice].
BACKGROUND
This article presents an update on causes and management of mastitis in general practice.


METHODS
Published articles on the causes and management of mastitis were identified by Medline and Embase searches, and reviewed. In addition, clinical experience from The National Breast-Feeding Centre in Norway is included.


CONCLUSIONS
Most studies report an incidence of mastitis of less than 20% though major methodological limitations make estimates difficult. Common symptoms of mastitis is a swollen, red, hot and painful breast, and systemic symptoms as fever occur frequently. Mastitis may be inflammatory or caused by microorganisms, and often secondary to milk stasis. Effective milk removal is a most essential part of the treatment and may make antibiotics superfluous. In most cases bacterial mastitis is caused by Staphylococcus aureus resistant to beta-lactamase sensitive antibiotics. Culture of the milk is necessary to determine the infecting organism and its antibiotic sensitivity. When antibiotics are warranted, dicloxacillin or cloxacillin are suggested as first-line drugs. The transfer of dicloxacillin/cloxacillin to breast milk is minimal. In most cases women with mastitis can continue to breast-feed also from the affected breast during treatment.
Nordeng
Hedvig
H
Institutt for farmakoterapi, Postboks 1065 Blindern, 0316 Oslo. h.m.e.nordeng@labmed.uio.no
Tufte
Elisabeth
E
Nylander
Gro
G
D000890:Anti-Infective Agents / Q000008:administration & dosage; D001942:Breast Feeding / Q000009:adverse effects; D005194:Family Practice; D005260:Female; D006801:Humans; D008413:Mastitis / Q000188:drug therapy / Q000382:microbiology / Q000628:therapy*; D012307:Risk Factors
D000890:Anti-Infective Agents