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Breast Infection

(continued)

Medications for Mastitis

For simple mastitis without an abscess, oral antibiotics are prescribed. Cephalexin (Keflex) and dicloxacillin (Dycill) are two of the most common antibiotics chosen, but a number of others are available. The antibiotic prescribed will depend on your specific situation, your doctor’s preference, and any drug allergies you may have. This medicine is safe to use while breastfeeding and will not harm the baby.

Chronic mastitis in nonbreastfeeding women can be complicated. Recurrent episodes of mastitis are common. Occasionally, this type of infection responds poorly to antibiotics. Therefore, close follow-up with your doctor is mandatory.

If the infection worsens in spite of oral antibiotics or if you have a deep abscess requiring surgical treatment, you may be admitted to the hospital for IV antibiotics.

Surgery for an Abscess

If an abscess is present, it must be drained. After injection of a local anesthetic, the doctor may drain an abscess near the surface of the skin either by aspiration with a needle and syringe or by using a small incision. This can be done in the doctor’s office or emergency department.

If the abscess is deep in the breast, however, it may require surgical drainage in the operating room. This procedure is usually done under general anesthesia to minimize pain and completely drain the abscess. Antibiotics and heat on the area are also used to treat abscesses.

Next Steps

Mastitis does not cause cancer, but cancer can mimic mastitis in appearance. If a breast infection is slow to go away, your health care provider may recommend a mammogram or other tests to rule out cancer.

Follow-Up Care After a Breast Infection

If you have a breast infection, you may be seen for a recheck in 24-48 hours.

  • Take all antibiotics as prescribed.
  • Take your temperature three times a day for the first 48 hours after treatment begins. Watch for fever.
  • Call your doctor if you develop a high fever, vomiting, or increasing redness, swelling, or pain in the breast.
  • Follow up with your doctor in one to two weeks to make sure that the infection has gone away. If the infection spreads or an abscess develops, you may require IV antibiotics or surgical treatment.

Mastitis Prevention

Sometimes mastitis is unavoidable. Some women are more susceptible than others, especially those who are breastfeeding for the first time. In general, good habits to prevent mastitis include the following:

  • Breastfeed equally from both breasts.
  • Empty breasts completely to prevent engorgement and blocked ducts.
  • Use good breastfeeding techniques to prevent sore, cracked nipples.
  • Avoid dehydration by drinking plenty of fluids.
  • Practice careful hygiene: Handwashing, cleaning the nipples, keeping your baby clean.

Outlook for Breast Infections

When treated promptly, the majority of breast infections go away quickly and without serious complications. Most women can and should continue to breastfeed despite an episode of uncomplicated mastitis. With proper treatment, symptoms should begin to resolve within one to two days.

A breast abscess may require surgical drainage, IV antibiotics, and a short hospital stay. A small incision is made and usually heals quite well. Prognosis for complete recovery is also good. 

Postmenopausal women with breast abscesses have a high rate of return after simple drainage and frequently need to follow up with a surgeon for more definitive treatment. Chronic infection can result if an abscess is not completely drained, and this can result in a poor cosmetic outcome.

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WebMD Medical Reference

Reviewed by Nivin Todd, MD, FACOG on October 27, 2013
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