Mastitis

Question 1

What is usually the causative agent for mastitis?

Answer 1

Staphylococcus aureus

Question 2

True/False
Infection in the nonlactating breast is common

Answer 2

FALSE
RARE

Question 3

Infection of (lactating or Non-lactating) Breast
Inflammatory carcinoma must always be considered
-Biopsy is indicated in the nonlactating breast when non responsive to antibiotics

Answer 3

Non-lactating

Question 4

Definition of what issue?
Occurs sporadically in nursing mothers, usually with symptom onset after discharge from the hospital

Answer 4

Postpartum mastitis

Question 5

S/s of what issue?
(1) Frequently begins within 3 months after delivery.
(2) Starts with an engorged breast and a sore or fissured nipple.
(3) Cellulitis is typically unilateral.
(a) Affected area of breast being red, tender, and warm.
(4) Fever and chills are common.

Answer 5

Mastitis

Question 6

Tx for mastitis
1( Symptomatic tx
2) MSSA antibiotics
vs
3) MRSA antibiotics

Answer 6

1) Symptomatic tx
Regular emptying of the breast
(a) Either with breastfeeding, pumping, or hand expression
(b) Nursing of the infected breast is safe for the infant

NSAIDS
1) Motrin is preferred and safe in lactation

2) MSSA Antibiotics
–Cephalexin (Keflex) 500mg PO QID 10-14
–Clindamycin 300 mg PO TID for 5-14 days

3) MRSA antibiotics
–Trimethoprim/sulfamethoxazole (Bactrim) PO q 12 hours for 5-14 days
–Clindamycin 300-450mg PO TID 5-14 days

Question 7

True/False
Nursing of the infected breast is safe for the infant

Answer 7

True

Question 8

Follow up for Mastitis
(1) Follow up within __ hours to ensure improvement.
(2) In the absence of improvement within ____ hours of initiating antibiotics patients should be referred to supervising physician or gynecologist for further evaluation.

Answer 8

1) 48
2) 72