Mastitis
Description General measures Medicine treatment Referral O91.2 DESCRIPTION Inflammation of the breast tissue surrounding the milk ducts. Risk factor includes retrograde infection from a fissured nipple and milk stasis. Commonly isolated pathogens include S. aureus and S. epidermidis. Presentation includes painful breast(s), fever, erythema and malaise. GENERAL MEASURES Compresses. Regular express
Description
General measures
Medicine treatment
Referral
O91.2
DESCRIPTION
Inflammation of the breast tissue surrounding the milk ducts.
Risk factor includes retrograde infection from a fissured nipple and milk stasis.
Commonly isolated pathogens include S. aureus and S. epidermidis. Presentation includes painful breast(s), fever, erythema and malaise.
GENERAL MEASURES
Compresses.
Regular expressing of breast milk.
Do not stop breastfeeding, unless a breast abscess has developed.
If breast abscess present, refer for incision and drainage.
MEDICINE TREATMENT
- Flucloxacillin, oral, 500 mg 6 hourly for 5 days.
Severe penicillin allergy:
Z88.0
Macrolide, e.g.:
- Azithromycin, oral, 500 mg daily for 3 days.
Pain:
- Paracetamol, oral, 500 mg to 1 g, 4 to 6 hourly as required (to a maximum of 4 g in 24 hours).
- Maximum dose: 15 mg/kg/dose.
REFERRAL
- Breast abscess.
- No improvement after 2 days.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2025-9_Version 1.0_26 March 2026
Chapter 6: Obstetrics and Gynaecology_6.7.4 Mastitis