Literature review for - Flourish Paediatrics

Quality P P 0 (No to 2, 3, 7)
Results
The study comparing two different
antibiotics found there was no
differences between the two
antibiotics for symptom relief.
The study comparing no treatment,
breast emptying, and antibiotic
therapy, found breast emptying
suggested more rapid symptom relief
with antibiotics.
In three trials of 471 women, there
was no significant differences in the
incidence
of mastitis between use of antibiotics
and no antibiotics RR= 0.43
(0.11,1.61), or in one
trial of 99 women comparing two
doses RR = 0.38 (0.02, 9.18).
No significant differences found for
mastitis in three
trials of specialist breastfeeding
education with usual care (one trial);
anti-secretory factor cereal (one trial);
and mupirocin, fusidic acid ointment
or breastfeeding advice (one trial).
If milk stasis or mastitis is suspected, an
ultrasound should be performed to
recognize early abscess
No indication for weaning in case of
milk stasis, puerperal mastitis (except
bilateral mastitis). Ineffective milk
removal even aggravates symptoms.
Initially, conservative therapeutic
measures should be tried for at least 24
hrs (antipyretics, physical rest,
substitution of liquids, frequent
breastfeeding, and emptying of the
affected breast)
If no improvement in mastitis can be
achieved by conservative therapies
antibiotics should be given. Antibiotics
should be changed if no change in
another 24 hrs.
Effect on risk
There is very little evidence on the
effectiveness of antibiotic therapy on
the treatment of mastitis, and more
research is needed.
Insufficient evidence to show
effectiveness of any of the
interventions, including breastfeeding
education, pharmacological
treatments and alternative therapies,
regarding the occurrence of mastitis or
breastfeeding exclusivity and duration.
Special emphasis on preventative
measures
Insufficient evidence to confirm or
refute the effectiveness of the different
therapies for the treatment of breast
diseases during lactation.
209