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Cited by 16Breastfeeding Practices and InfluencesBreast Lesions and CarcinomasMilk Quality and Mastitis in Dairy Cows

Abscess Drainage with or Without Antibiotics in Lactational Breast Abscess: Study Protocol for a Randomized Controlled Trial

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Luo, Jiayue, Long, Tianzhu, Cai, Yuanxuan, Teng, Yuan, Fan, Zhe, Liang, Zhen, Zhu, Cairong, Ma, Hongmin +1 more·2020·Infection and Drug Resistance
DOI 10.2147/idr.s221037PMC PMC6983478
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Abstract

BACKGROUND: Lactational breast abscess, a complication from lactational mastitis, is a common cause of breastfeeding discontinuation. No consensus has been reached regarding the necessity of antibiotics in this disease. The purpose of this trial is to determine if surgical drainage is non-inferior to drainage together with a standard course of antibiotics, in the treatment of lactational breast abscess. METHODS: Breastfeeding females with breast abscess from 18 to 50 years old are eligible for study inclusion. An expected number of 306 patients will be randomly allocated in parallel to the intervention arm (simple drainage without antibiotics) or the control arm (abscess drainage with standard 5-day-course of antibiotics). The primary outcomes include the time to resolution of breast abscess and disease recurrence rate. Secondary outcomes of interests are 3-day-improvement proportion, rate of continuing breastfeeding, treatment failure rate, procedural-related complications, and length of hospital stay. An expected non-inferiority margin for the difference in the primary outcome of interest is set at 1 day, on the basis of a one-sided 97.5% confidence interval. DISCUSSION: This trial will provide first-hand evidence on whether simple abscess drainage is non-inferior to drainage together with a standard course of antibiotics, in lactational mothers with breast abscess. The indication of antibiotic prophylaxis could be revised if non-inferiority is set up, and guidelines for lactational breast abscess require amendments correspondingly. TRIAL REGISTRATION: This study has been registered in the Chinese Clinical Trial Registry, and the trial registration number is ChiCTR1900024008.

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  1. [2]Amir LH. ABM clinical protocol #4: mastitis, revised March 2014. Breastfeeding Med. 2014; 9(5): 239– 243. doi: 10.1089/bfm.2014.9984 PMC4048576 24911394 · DOI · Paper page
  2. [3]Bharat A, Gao F, Aft RL, Gillanders WE, Eberlein TJ, Margenthaler JA. Predictors of primary breast abscesses and recurrence. World J Surg. 2009; 33(12): 2582– 2586. doi: 10.1007/s00268-009-0170-8 19669231 PMC3892669 · DOI
  3. [4]Foxman B, D’Arcy H, Gillespie B, Bobo JK, Schwartz K. Lactation mastitis: occurrence and medical management among 946 breastfeeding women in the United States. Am J Epidemiol. 2002; 155(2): 103– 114. doi: 10.1093/aje/155.2.103 11790672 · DOI · Paper page
  4. [5]Kataria K, Srivastava A, Dhar A. Management of lactational mastitis and breast abscesses: review of current knowledge and practice. Indian J Surg. 2013; 75(6): 430– 435. doi: 10.1007/s12262-012-0776-1 PMC3900741 24465097 · DOI
  5. [6]Amir LH, Forster D, McLachlan H, Lumley J. Incidence of breast abscess in lactating women: report from an Australian cohort. BJOG. 2004; 111(12): 1378– 1381. doi: 10.1111/bjo.2004.111.issue-12 15663122 · DOI
  6. [7]Merz L, De Courten C, Orasch C. [Breast infections]. Rev Med Suisse. 2014; 10(427): 925–926, 928–930. 24843990
  7. [9]Ahluwalia IB, Morrow B, Hsia J. Why do women stop breastfeeding? Findings from the pregnancy risk assessment and monitoring system. Pediatrics. 2005; 116(6): 1408– 1412. doi: 10.1542/peds.2005-0013 16322165 · DOI
  8. [10]Dennis CL, Schottle N, Hodnett E, McQueen K. An all-purpose nipple ointment versus lanolin in treating painful damaged nipples in breastfeeding women: a randomized controlled trial. Breastfeeding Med. 2012; 7(6): 473– 479. doi: 10.1089/bfm.2011.0121 22428572 · DOI
  9. [11]Leung SS. Breast pain in lactating mothers. Hong Kong Med j. 2016; 22(4): 341– 346. doi: 10.12809/hkmj154762 27313273 · DOI
  10. [12]Kvist LJ, Rydhstroem H. Factors related to breast abscess after delivery: a population-based study. BJOG. 2005; 112(8): 1070– 1074. doi: 10.1111/bjo.2005.112.issue-8 16045520 · DOI
  11. [13]Branch-Elliman W, Lee GM, Golen TH, Gold HS, Baldini LM, Wright SB. Health and economic burden of post-partum Staphylococcus aureus breast abscess. PLoS One. 2013; 8(9): e73155. doi: 10.1371/journal.pone.0073155 24039877 PMC3764182 · DOI
  12. [14]Chen CY, Anderson BO, Lo SS, Lin CH, Chen HM. Methicillin-resistant Staphylococcus aureus infections may not impede the success of ultrasound-guided drainage of puerperal breast abscesses. J Am Coll Surg. 2010; 210(2): 148– 154. doi: 10.1016/j.jamcollsurg.2009.11.003 20113934 · DOI · Paper page
  13. [15]Gould IM. Antibiotics, skin and soft tissue infection and meticillin-resistant Staphylococcus aureus: cause and effect. Int J Antimicrob Agents. 2009; 34(Suppl 1): S8– 11. doi: 10.1016/S0924-8579(09)70542-4 19560675 · DOI
  14. [16]Moazzez A, Kelso RL, Towfigh S, Sohn H, Berne TV, Mason RJ. Breast abscess bacteriologic features in the era of community-acquired methicillin-resistant Staphylococcus aureus epidemics. Arch Surg. 2007; 142(9): 881– 884. doi: 10.1001/archsurg.142.9.881 17891866 · DOI · Paper page
  15. [17]Schoenfeld EM, McKay MP. Mastitis and methicillin-resistant Staphylococcus aureus (MRSA): the calm before the storm? J Emerg Med. 2010; 38(4): e31– e34. doi: 10.1016/j.jemermed.2008.11.021 19232875 · DOI
  16. [18]Chen KT, Huard RC, Della-Latta P, Saiman L. Prevalence of methicillin-sensitive and methicillin-resistant Staphylococcus aureus in pregnant women. Obstet Gynecol. 2006; 108(3 Pt 1): 482– 487. doi: 10.1097/01.AOG.0000227964.22439.e3 16946204 · DOI
  17. [19]Dixon JM, Khan LR. Treatment of breast infection. BMJ. 2011; 342: d396. doi: 10.1136/bmj.d396 21317199 · DOI
  18. [21]Schwarz RJ, Shrestha R. Needle aspiration of breast abscesses. Am J Surg. 2001; 182(2): 117– 119. doi: 10.1016/S0002-9610(01)00683-3 11574080 · DOI
  19. [22]Ozseker B, Ozcan UA, Rasa K, Cizmeli OM. Treatment of breast abscesses with ultrasound-guided aspiration and irrigation in the emergency setting. Emerg Radiol. 2008; 15(2): 105– 108. doi: 10.1007/s10140-007-0683-0 18193464 · DOI
  20. [23]Falco G, Foroni M, Castagnetti F, et al. Ultrasound-guided percutaneous catheter drainage of large breast abscesses in lactating women: how to preserve breastfeeding safely. Breastfeeding Med. 2016; 11: 555– 556. doi: 10.1089/bfm.2016.0121 27726424 · DOI
  21. [24]Christensen AF, Al-Suliman N, Nielsen KR, et al. Ultrasound-guided drainage of breast abscesses: results in 151 patients. Br J Radiol. 2005; 78(927): 186– 188. doi: 10.1259/bjr/26372381 15730981 · DOI
  22. [25]Berna-Serna JD, Madrigal M, Berna-Serna JD. Percutaneous management of breast abscesses. An experience of 39 cases. Ultrasound Med Biol. 2004; 30(1): 1– 6. doi: 10.1016/j.ultrasmedbio.2003.10.003 14962601 · DOI
  23. [26]Marin M, Arroyo R, Espinosa-Martos I, Fernandez L, Rodriguez JM. Identification of emerging human mastitis pathogens by MALDI-TOF and assessment of their antibiotic resistance patterns. Front Microbiol. 2017; 8: 1258. doi: 10.3389/fmicb.2017.01258 28747897 PMC5506187 · DOI
  24. [27]Delgado S, Arroyo R, Jimenez E, et al. Staphylococcus epidermidis strains isolated from breast milk of women suffering infectious mastitis: potential virulence traits and resistance to antibiotics. BMC Microbiol. 2009; 9: 82. doi: 10.1186/1471-2180-9-82 19422689 PMC2685400 · DOI
  25. [28]Dinsmoor MJ, Viloria R, Lief L, Elder S. Use of intrapartum antibiotics and the incidence of postnatal maternal and neonatal yeast infections. Obstet Gynecol. 2005; 106(1): 19– 22. doi: 10.1097/01.AOG.0000164049.12159.bd 15994612 · DOI
  26. [29]Dabbas N, Chand M, Pallett A, Royle GT, Sainsbury R. Have the organisms that cause breast abscess changed with time?–implications for appropriate antibiotic usage in primary and secondary care. Breast J. 2010; 16(4): 412– 415. doi: 10.1111/j.1524-4741.2010.00923.x 20443790 · DOI
  27. [32]Spellberg B. The new antibiotic mantra-”shorter is better”. JAMA Intern Med. 2016; 176(9): 1254– 1255. doi: 10.1001/jamainternmed.2016.3646 27455385 PMC5233409 · DOI · Paper page
  28. [33]Boucher HW. Partial oral therapy for osteomyelitis and endocarditis - is it time? N Engl J Med. 2019; 380(5): 487– 489. doi: 10.1056/NEJMe1817264 30699312 · DOI
  29. [34]Jianu DM, Sandulescu O, Streinu-Cercel A, et al. Microbiologic safety of the transareolar approach in breast augmentation. Aesthetic Surg j. 2016; 36(1): 51– 57. doi: 10.1093/asj/sjv106 26590196 · DOI
  30. [35]Jianu DM, Streinu-Cercel A, Blidaru A, et al. Breast ecology assessment in the study of local microflora - study protocol. Germs. 2013; 3(1): 14– 17. doi: 10.11599/issn.2248-2997 24432281 PMC3882839 · DOI
  31. [36]Streinu-Cercel A, Jianu DM, Sandulescu O, Streinu-Cercel A. Response to “commentary on: microbiologic safety of the transareolar approach in breast augmentation. Aesthetic Surg j. 2016; 36(4): Np177. doi: 10.1093/asj/sjv264 PMC4784528 26883218 · DOI
  32. [37]David M, Handa P, Castaldi M. Predictors of outcomes in managing breast abscesses-A large retrospective single-center analysis. Breast J. 2018; 24(5): 755– 763. doi: 10.1111/tbj.2018.24.issue-5 29781232 · DOI
  33. [38]Trop I, Dugas A, David J, et al. Breast abscesses: evidence-based algorithms for diagnosis, management, and follow-up. Radiographics. 2011; 31(6): 1683– 1699. doi: 10.1148/rg.316115521 21997989 · DOI
  34. [39]Gollapalli V, Liao J, Dudakovic A, Sugg SL, Scott-Conner CE, Weigel RJ. Risk factors for development and recurrence of primary breast abscesses. J Am Coll Surg. 2010; 211(1): 41– 48. doi: 10.1016/j.jamcollsurg.2010.04.007 20610247 · DOI
  35. [40]Giess CS, Golshan M, Flaherty K, Birdwell RL. Clinical experience with aspiration of breast abscesses based on size and etiology at an academic medical center. J Clin Ultrasound. 2014; 42(9): 513– 521. doi: 10.1002/jcu.v42.9 24975466 · DOI
  36. [41]Versluijs-Ossewaarde FN, Roumen RM, Goris RJ. Subareolar breast abscesses: characteristics and results of surgical treatment. Breast J. 2005; 11(3): 179– 182. doi: 10.1111/j.1075-122X.2005.21524.x 15871702 · DOI

Cited by

Sorted by citations

Authors
Luo, J., Long, T., Cai, Y., Teng, Y., Fan, Z., Liang, Z., Zhu, C., Ma, H., & Li, G.
Affiliations
Guangzhou Women and Children Medical Center (CN)
Corresponding author
  • Luo, Jiayue
  • Long, Tianzhu
  • Cai, Yuanxuan
  • Teng, Yuan
  • Fan, Zhe
  • Liang, Zhen
  • Zhu, Cairong
  • Ma, Hongmin
  • Li, Guanhua
ORCID
Venue
Infection and Drug Resistance
Publisher
Informa UK Limited
Published
2020-01
Volume
Volume 13
Pages
183-190
ISSN
1178-6973 (ISSN-L)
DOI
10.2147/idr.s221037
PMC
PMC6983478
OpenAlex
W2999761783
Cited by
16
References
5
Citations by year
2026: 2 · 2025: 2 · 2024: 2 · 2022: 4 · 2021: 4 · 2020: 2
FWCI
1.79
Type
journal article
Language
en
Open access
Licence
Locations
  • Infection and Drug Resistance (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Breast Lesions and Carcinomas
  • Life Sciences › Agricultural and Biological Sciences › Agronomy and Crop Science › Milk Quality and Mastitis in Dairy Cows
Keywords
abscess drainage, antibiotic prophylaxis, lactational mastitis, breastfeeding, non-inferiority, recurrence, treatment failure, length of hospital stay

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