Mastitis

Treatment of mastitis/ breast abscess associated with lactation
Flucloxacillin
Flucloxacillin 500mg capsules

1g every 6 hours for 7 days

Flucloxacillin 250mg/5ml oral solution sugar free

1g every 6 hours for 7 days

In penicillin allergy

Clarithromycin
Clarithromycin 500mg tablets

500mg every 12 hours for 7 days

Clarithromycin 250mg/5ml oral suspension

500mg every 12 hours for 7 days

Prescribing Notes:

  • Treatment course: 7 days depending on clinical response. Infections should begin to respond within 48 hours.  If the infection is worsening despite oral antibiotics then seek help from obstetricians, breast unit surgeons or microbiologist. Send a swab of the breast and a MRSA screen if there are risk factors for MRSA infection. 
  • Management of lactation mastitis in hospital (secondary care) see local board antimicrobial prescribing guidance.

History Notes

16/06/2025

Prescribing information updated, ERFC April 25.

24/04/2025

Prescribing information updated, ERFC April 2025

06/06/2024

Erythromycin ethyl succinate 500mg/5ml oral suspension sugar free discontinued and removed

15/12/2021

East Region Formulary content agreed.

Treatment of mastitis/ breast abscess not associated with lactation

See 2nd choice, for choice for frail/elderly

Co-amoxiclav
Co-amoxiclav 500mg/125mg tablets

625mg every 8 hours for 7 days

Co-amoxiclav 250mg/62mg/5ml oral suspension sugar free

625mg every 8 hours for 7 days

For the frail/elderly

Flucloxacillin
Flucloxacillin 500mg capsules

500mg every 6 hours for 7 days

Flucloxacillin 250mg/5ml oral solution sugar free

500mg every 6 hours for 7 days

Metronidazole
Metronidazole 400mg tablets

400mg every 8 hours for 7 days

Metronidazole 200mg/5ml oral suspension

400mg every 8 hours for 7 days

If allergic to penicillin

Clarithromycin
Clarithromycin 500mg tablets

500mg every 12 hours for 7 days

Clarithromycin 250mg/5ml oral suspension

500mg every 12 hours for 7 days

Metronidazole
Metronidazole 400mg tablets

400mg every 8 hours for 7 days

Metronidazole 200mg/5ml oral suspension

400mg every 8 hours for 7 days

History Notes

15/12/2021

East Region Formulary content agreed.