Treatment of Mastitis in the Inpatient Setting

Initial Assessment and Management

• The American Academy of Pediatrics recommends continued breastfeeding or milk expression from the affected breast as this is an essential part of treatment, helping prevent milk stasis and considered an adjunct to other treatments 1, 2
• Regular feeding or expression of milk is beneficial for patients with mastitis, as it helps prevent milk stasis and is considered an adjunct to other treatments 2

Antibiotic Therapy

• For suspected or confirmed MRSA, vancomycin (with appropriate therapeutic monitoring) is recommended, and linezolid may be superior to vancomycin for MRSA pneumonia and could be considered for severe cases, while daptomycin may be preferred for MRSA with vancomycin MIC >1 mg/L 3

Management of Complications

• Approximately 10% of mastitis cases progress to breast abscess formation, which requires drainage, either by surgical incision or needle aspiration, and breastfeeding can continue on the affected side as long as the infant's mouth does not contact purulent drainage 2

Special Considerations

• Discontinuing breastfeeding during mastitis treatment can worsen the condition and is not recommended, according to the Praxis Medical Insights guideline 1