I see this as a very complex subject, for which there are no easy answers.  IF good drainage could be achieved in the early hours of the onset of symptoms, I believe we could reduce the need for antibiotics, but only reduce.  I recently saw a woman 10 days postpartum, with badly damaged nipples, febrile, experiencing flu symptoms.  She had inflammation and oedema of one breast and was not able to nurse from that side (baby could not attach).  Attempts at manual expressing yielded only slow drips of milk.  Gentle 2-hand massage of the breast seemed the best way to achieve what little flow there was.  I have no doubt that this woman required appropriate antibiotic therapy, which she accepted.
When I was breastfeeding my children I had frequent bouts of mastitis.  The sudden onset of nipple pain (nipples were never cracked), breast fullness, fever, shivers, general flu symptoms - usually happened after I tried to do too much, or stayed up late or put off feeding the baby for whatever reason.  After the first couple of episodes, when I took antibiotics, I learnt how to manage it without medication.  My treatment was to 
favour the affected breast when feeding (drainage), 
massage the affected area during the feed (drainage), 
take paracetemol (anti-inflammatory)
have a hot deep bath (felt good - started the sweating)
lots of clear fluids (replace + extra)
vitamin C every couple of hours 
go to bed - cancel any plans for the day - get help with the children. 
I would usually have a big sweat after the bath, feel tired, and go to sleep.  After I learnt this process I avoided using antibiotics completely.  You know it's working because the nipple pain and other symptoms disappear.  The affected area of breast tissue feels tender, but not painful for a few days.

Joy Johnston, Midwife FACM IBCLC
Melbourne, Australia