Hello All-
Speaking of evidence-based practice, has anyone read this Cochrane review
which suggests that their is insufficient evidence for the efficacy of
antibiotics for mastitis!?
Cochrane Database Syst
Rev.<javascript:AL_get(this,%20'jour',%20'Cochrane%20Database%20Syst%20Rev.');>
2009
Jan 21;(1):CD005458.
Antibiotics for mastitis in breastfeeding women.
Jahanfar S<http://www.ncbi.nlm.nih.gov/pubmed?term=%22Jahanfar%20S%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>
, Ng CJ<http://www.ncbi.nlm.nih.gov/pubmed?term=%22Ng%20CJ%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>
, Teng CL<http://www.ncbi.nlm.nih.gov/pubmed?term=%22Teng%20CL%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract>
.
Department of Public Health, Royal College of Medicine Perak, No 3,
Greentown Street, Ipoh, Perak, Malaysia, 30450. [log in to unmask]
BACKGROUND: Mastitis can be caused by ineffective positioning of the baby at
the breast or restricted feeding. Infective mastitis is commonly caused by
Staphylococcus Aureus. Incidence of mastitis in breastfeeding women may
reach 33%. Effective milk removal, pain medication and antibiotic therapy
have been the mainstays of treatment. OBJECTIVES: This review aims to
examine the effectiveness of antibiotic therapies in relieving symptoms for
breastfeeding women with mastitis with or without laboratory investigation.
SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's
Trials Register (December 2007), the Cochrane Central Register of Clinical
Trials (The Cochrane Library 2007, Issue 4), MEDLINE (1996 to 2007) and
EMBASE (January 1985 to 2007). We contacted investigators and other content
experts known to us for unpublished trials and scanned the reference lists
of retrieved articles SELECTION CRITERIA: Randomized and quasi-randomized
clinical trials comparing the effectiveness of various types of antibiotic
therapies or antibiotic therapy versus alternative therapies for the
treatment of mastitis were selected. DATA COLLECTION AND ANALYSIS: Two
authors independently assessed trial quality and extracted data. When in
dispute, we consulted a third author. MAIN RESULTS: Two trials met the
inclusion criteria. One small trial (n = 25) compared amoxicillin with
cephradine and found no significant difference between the two antibiotics
in terms of symptom relief and abscess formation. Another, older study
compared breast emptying alone as "supportive therapy" versus antibiotic
therapy plus supportive therapy, and no therapy. The findings of the latter
study suggested faster clearance of symptoms for women using antibiotics,
although the study design was problematic. AUTHORS' CONCLUSIONS: There is
insufficient evidence to confirm or refute the effectiveness of antibiotic
therapy for the treatment of lactational mastitis. There is an urgent need
to conduct high-quality, double-blinded randomized clinical trials to
determine whether antibiotics should be used in this common postpartum
condition.
Molly
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