I'm resending this becoz it is quite helpful, but it showed up to lactnet
kind of bunched together. Frank, if you would verify this is correct the way
I am reposting?
Laurie

Date:    Mon, 1 Mar 2010 12:24:33 +0000
From:    "Frank J. Nice" <[log in to unmask]>
Subject: Mastitis Algorithm
 Mastitis Antibiotic Algorithm Nursing mothers who develop breast abscesses
or mastitis one to four weeks postpartum should be considered as having
penicillin-resistant staphylococcal infections.
Drug treatment options in order of preference are:
1. Penicillinase-Resistant Penicillins: dicloxacillin (first choice),
cloxacillin, methicillin, nafcillin
2. Macrolides (if allergic to penicillins): azithromycin (first choice),
clarithromycin
3. Aminoglycosides: clindamycin, vancomycin (IV) (if incision and drainage
necessary)
4. Sulfamethoxazole/trimethoprim (oral): (if incision and drainage
necessary)
5. Cephalosporins
6. Linezolid (high rate of thromboplastinemia)
7. Kanamycin
8. Chloramphenicol (do not breastfeed if this drug is
necessary)
PLUS analgesic / antipyretic relief as needed

Frank J. Nice, RPh, DPA, CPHP
Check out my new website and book, "Nonprescription Drugs for the
Breastfeeding Mother" at:
www.nicebreastfeeding.com

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