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 (methicillin, oxacillin,
nafcillin, cloxacillin, dicloxacillin)
2. Cephalosporins (cephalothin, cefazolin, cefalexin, cephradine,
cefamandole, cefoxitin, third-generation
cephalosporins)
3. Aminoglycosides (gentamtycin, vancomycin, lincomycin,
clindamycin)
4. Erythromycins (non-estolates)
5. Macrolides (azithromycin, clarithromycin, dithromycin)
6. Kanamycin
7. Bacitracin (do not breastfeed if this drug is necessary)
8. Chloramphenicol (do not breastfeed if this drug is necessary)
9. Sulmethoxazole/trimethoprim
PLUS analgesic / antipyretic relief as needed
Frank J. Nice, DPA, CPHP
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