Antibiotics for mastitis in breastfeeding women

Jahanfar, Shayesteh; Ng, Chirk Jenn; Teng, Cheong Lieng

doi:10.1590/1516-3180.20161343t1

Cited by 25 publications

(18 citation statements)

References 1 publication

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“…Nipple pain is experienced by 30% to 90% of women and tends to peak around the third day postpartum (Morland-Schultz Mastitis defined by at least two breast symptoms (pain, redness or lump) and at least one of fever or flu-like symptoms occurs in 17% to 33% of breastfeeding women, with most episodes occurring in the first 4 weeks (Amir et al, 2007 Level IV; Jahanfar et al, 2009 Level I). Infective mastitis is most commonly from Staphylococcus aureus, and non-infective mastitis is equally common.…”

Section: Breast Painmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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Section: Breast Painmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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“…Medidas generales • Recomendaciones para mantener la lactancia; apoyo emocional para afrontar el dolor y la incomodidad. 1,10 • Adecuada nutrición, hidratación y reposo.…”

Section: 20-22unclassified

Mastitis. Puesta al día

2016

Arch Argent Pediat

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RESUMENLa mastitis es una de las principales causas de abandono evitable de la lactancia materna, con el aumento de la morbimortalidad infantil que ello supone, pero no hay uniformidad en los criterios diagnósticos ni terapéuticos. El diagnóstico de la mastitis aguda es fundamentalmente clínico, y, solo en determinados casos, está indicado el cultivo de leche. El drenaje del pecho es fundamental en el tratamiento, por lo que debe mantenerse la lactancia. Si persisten los síntomas o si existe mucha repercusión clínica, se iniciará la antibioterapia. No hay pruebas suficientes de la etiopatogenia de otros tipos de mastitis (subclínica y subaguda) ni de que sean responsables del dolor mamario o el escaso aumento ponderal del lactante. Tampoco sobre la efectividad de los probióticos en el tratamiento y prevención de la mastitis. El objetivo es realizar una evaluación de la información disponible sobre la clínica, diagnóstico y tratamiento de las mastitis para ofrecer una visión actualizada del tema. Palabras clave: mastitis aguda, mastitis subaguda, probióticos, mastodinia. ABSTRACTMastitis is one of the main causes of avoidable cessation of breastfeeding which increases morbidity in childhood, however, there is no uniformity in diagnostic and therapeutic criteria. The diagnosis of acute mastitis is mainly clinical. Only in certain cases, a milk culture is indicated. Regarding treatment of mastitis, it is fundamental to empty the breast, so breastfeeding should continue. It is recommended to start antibiotic therapy if symptoms persist or if there is considerable clinical impact. There is insufficient evidence of the importance of other types of mastitis (subclinical and subacute). There is also a lack of evidence that these types of mastitis are responsible for breast pain or for low infant weight gain. Furthermore, there is not enough evidence regarding the effectiveness of probiotics in the treatment and prevention of mastitis.The aim of this article is to review the available information related to clinical signs, diagnosis and management of acute mastitis in order to give an updated overview.

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“…Infective mastitis is most commonly from Staphylococcus aureus, and non-infective mastitis is equally common. Currently, there is insufficient evidence to confirm efficacy for antibiotics in relieving symptoms, but only two trials met the inclusion criteria for analysis (Jahanfar et al, 2009 Level I).…”

Section: Breast Painmentioning

confidence: 99%

Safety of opioid patch initiation in Australian residential aged care

Gadzhanova

Roughead

Pont

2015

Medical Journal of Australia

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Objective: To explore opioid use by aged care facility residents before and after initiation of transdermal opioid patches. Design: A cross‐sectional cohort study, analysing pharmacy data on individual patient supply between 1 July 2008 and 30 September 2013. Setting: Sixty residential aged care facilities in New South Wales. Participants: Residents receiving an initial opioid patch during the study period. Main outcome measure: The proportion of residents who were opioid‐naive in the 4 weeks prior to patch initiation was determined. In addition, the patch strength at initiation and the daily dose of transdermal patches and of additional opioids 1 month after initiation were determined. Results: An opioid patch was initiated in 596 of 5297 residents (11.3%: 2.6% fentanyl, 8.7% buprenorphine) in the 60 residential aged care facilities. The mean age at initiation was 87 years, and 74% of the recipients were women. The proportion of recipients who were opioid‐naive before patch initiation was 34% for fentanyl and 49% for buprenorphine. Most were initiated at the lowest available patch strength, and the dose was up‐titrated after initiation. Around 15% of fentanyl users and 10% of buprenorphine users needed additional regular opioids after patch initiation. Conclusions: The results suggest some inappropriate initiation of opioid patches in Australian residential aged care facilities. Contrary to best practice, a third of residents initiated on fentanyl patches were opioid‐naive in the 4 weeks before initiation.

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Antibiotics for mastitis in breastfeeding women

Abstract: There is insufficient evidence to confirm or refute the effectiveness of antibiotic therapy for the treatment of lactational mastitis. There is an urgent need to conduct high-quality, double-blinded RCTs to determine whether antibiotics should be used in this common postpartum condition.

Cited by 25 publications

References 1 publication

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Mastitis. Puesta al día

Safety of opioid patch initiation in Australian residential aged care

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