Amir Lisa H, Coca Kelly P, Mello Da Silva Marcia Juliana, Okada Marcia Massumi, Onat Demir Güliz, Duran Busra, Kargin Süleyman, Güllü Kübra, Delic Lara, Dragicevic Magdalena, Rosenbauer Maria, Ngan Mee-Har Michelle, Jeong Wirawan, Saha Moni Rani, Zakarija-Grkovic Irena
Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Bundoora, VIC, Australia.
Breastfeeding Service, Royal Women's Hospital, Parkville, VIC, Australia.
J Hum Lact. 2025 Aug;41(3):401-411. doi: 10.1177/08903344251338245. Epub 2025 May 28.
Breastfeeding is strongly promoted by health authorities, but there is little research on whether health professionals provide best-practice care for women experiencing mastitis/breast abscess.
To explore management of mastitis/breast abscess in hospital emergency departments (EDs).
Medical records of patients presented to hospital EDs in Australia, Brazil, Croatia, Germany and Türkiye with lactational mastitis/abscess between 2017 and 2023 were reviewed. Demographic and clinical information (including symptoms, management, and investigations) was extracted and analyzed.
A total of 580 women with mastitis/breast abscess (646 Emergency Department presentations, mostly in the first 8 weeks postpartum) were identified during the study period. The majority of the women had symptoms of mastitis/breast abscess (breast pain, lump, and inflammation) for > 48 hours before presenting in the Emergency Department. In Australia, culture and sensitivity testing of milk was available for 44% (146/331) of presentations. was the most common bacteria isolated (33%, = 48), of which 6% ( = 3) were methicillin-resistant. The use of diagnostic ultrasound varied between sites, from 5% (3/65) in Croatia to 82% (40/49) in Germany. Breast abscesses were mostly managed by ultrasound-guided aspiration in Australia, whereas incision and drainage was standard care in Germany. Amoxicillin/clavulanate was most commonly prescribed in Croatia (57%, 31/54) and Türkiye (69%, 28/42), whereas flucloxacillin, cephalexin, or cefuroxime was primarily used in Australia (86%, 272/322), Brazil (62%, 66/106), or Germany (80%, 33/41), respectively.
The management of mastitis/breast abscess varied considerably between countries. International evidence-based guidelines for the management of lactational mastitis are urgently needed.
卫生当局大力提倡母乳喂养，但关于卫生专业人员是否为患有乳腺炎/乳房脓肿的女性提供最佳实践护理的研究很少。
探讨医院急诊科对乳腺炎/乳房脓肿的管理。
回顾了2017年至2023年期间在澳大利亚、巴西、克罗地亚、德国和土耳其的医院急诊科就诊的患有哺乳期乳腺炎/脓肿患者的病历。提取并分析了人口统计学和临床信息（包括症状、管理和检查）。
在研究期间共确定了580名患有乳腺炎/乳房脓肿的女性（646次急诊科就诊，大多在产后前8周）。大多数女性在前往急诊科就诊前，乳腺炎/乳房脓肿症状（乳房疼痛、肿块和炎症）持续超过48小时。在澳大利亚，44%（146/331）的就诊病例进行了乳汁培养和药敏试验。金黄色葡萄球菌是最常见分离出的细菌（33%，n = 48），其中6%（n = 3）为耐甲氧西林金黄色葡萄球菌。诊断性超声的使用在不同地点有所不同，从克罗地亚的5%（3/65）到德国的82%（40/49）。在澳大利亚，乳房脓肿大多通过超声引导下穿刺抽吸进行处理，而在德国，切开引流是标准治疗方法。在克罗地亚（57%，31/54）和土耳其（69%，28/42），最常开具的药物是阿莫西林/克拉维酸，而在澳大利亚（86%，272/322）、巴西（62%，66/106）或德国（80%，33/41），分别主要使用氟氯西林、头孢氨苄或头孢呋辛。
各国对乳腺炎/乳房脓肿的管理差异很大。迫切需要基于国际循证的哺乳期乳腺炎管理指南。
