Mastitis Antibiotic Algorithm Nursing mothers who develop breast abscesses or mastitis one to four weekspostpartum should be considered as having penicillin-resistantstaphylococcal infections.  Drug treatment options in order of preferenceare:1.        Penicillinase-Resistant Penicillins: dicloxacillin (first choice), cloxacillin, methicillin, nafcillin2.        Macrolides (if allergic to penicillins): azithromycin (first    choice), clarithromycin3.     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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