This protocol is for lactational mastitis presenting with localised inflammatory features — pain, erythema, heat, and swelling of the breast — in a breastfeeding woman who has a documented penicillin allergy. The penicillin allergy is the key factor that shapes the antibiotic component of management.
Standard antibiotic regimens for lactational mastitis typically rely on penicillin-based agents. Where a penicillin allergy is confirmed, a different antibiotic pathway applies. For patients allergic to penicillin, options include cephalexin or clindamycin.
Management combines oral analgesia as the analgesic foundation, physical measures applied in relation to feeding, and regular, complete drainage of the affected breast. Because standard first-line antibiotics are not suitable here, the antibiotic component follows an alternative pathway specific to the penicillin-allergic patient. The complete structured regimen — including sequencing, agents, and clinical guidance — is available in full via the link below.