Lactational mastitis is an inflammatory process affecting the lactating breast. This protocol applies to patients without penicillin allergy whose breast inflammation has not resolved despite an initial course of oral antibiotic therapy and supportive measures.
The patient presents with lactational mastitis and has no penicillin allergy. Management has progressed to this point because the expected improvement — settling of breast inflammation by the 24–48 hour review — was not achieved with the first-line approach.
The preceding step included oral paracetamol, non-steroidal anti-inflammatory drugs, warm and cold compresses, oral flucloxacillin or dicloxacillin, and encouraged breast drainage. Escalation to this protocol is indicated when breast inflammation has not settled by the 24–48 hour review mark.
When systemic signs of sepsis are present, this situation warrants a hospital-based intervention involving intravenous antibiotics. The specific antibiotic selection, clinical pathway, and full management detail are available in the complete protocol below.