Hello,  I recently had a mom with an infection that responded poorly to
dicloxacillan.   In addition,  I had another mom with a staph infection that
was resistant to all but Gentamycin and Septra.  Thirdly,  I had a mom who
was treated for mastitis and then developed ductal thrush.

So when my mom did not respond to diclox.  I suggested that she be placed on
Septra and Augmentin and be given diflucan as well.  If her nipple  is sore
at all I would treat with gynelotrimin and bactroban.  THis mother cleared up
quickly with this regimen but she did devlop some diarhhea from the
antibiotics.   The baby is thriving.

If I were caring for this mom--I would do a culture of the milk after
expressing several drops of it.  I would also as you suggested get her old
records before making a decision.  The mother may need to be hopsitalized and
placed on IV antibiotics.  Consideration for ORSA  (oxacillan resistant
staph)  should be given.   It is unlikly but,  the infant may be need to be
cultured and potentially treated if mother develops an abscess.

Hope this helps.  Good  luck.  Christine Betzold MSN NP IBCLC
www.starfireinternational.net/breastfed

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