Recurrence Of Mastitis Research Articles

Financial implications of treating nonsevere Gram-negative clinical mastitis in three California dairies

On 3 large California dairies, 415 lactating cows with nonsevere clinical mastitis (CM) and infected with Gram-negative (GN) bacteria were randomly assigned to one of 3 treatment groups: nontreated control (CON - 135 cases), 2d ceftiofur HCl (SP2 - 133 cases), or 5d ceftiofur HCl (SP5 - 147 cases). Bacteriological cure (BC), clinical cure (CC), mastitis recurrence (MR), culling/death, and overall treatment success differed among treatment groups. Although duration of milk withheld due to mastitis therapy was higher for SP5 (9.4 d), there was no difference between CON (6.9 d) and SP2 (7.1 d). Culling and death rates due to GN CM were the main effects that impacted partial cost calculations. Of study cows culled across the 3 herds, a higher proportion of CON cows (25%) were culled compared with SP2 (11%) or SP5 (18%). Mastitis-related expenses were higher ($550) for CON than SP2 ($343) or SP5 ($423). Results of this partial budget evaluation for the 3 California dairies indicated economic justification for treating cases of nonsevere GN CM with ceftiofur HCl for 2 d.

Rotational gland dissection for refractory granulomatous mastitis: A single-center retrospective study

BackgroundRefractory granulomatous mastitis (RGM) is a chronic benign breast disease that commonly occurred in women of childbearing age and is usually treated with surgery, with numerous cases suffering from unsatisfied postoperative recovery of breast shape, high rates of surgical complications, and even high recurrence. This study tries to evaluate the efficacy of an innovative surgical procedure, the rotational gland dissection for the treatment of RGM. Methods129 patients with RGM who underwent surgical treatment at the Second Affiliated Hospital of Xi'an Jiaotong University between Apr. 2017 and May. 2021 were retrospectively included in this study. The article analyzed the age, local symptoms, lesion location, and size, days in hospital, recurrence rate, and satisfaction rate of the patients. ResultsPatients ranged in age from 19 to 58 years, with a median age of onset of 32 years. In 63 patients (48.84%), their lesions coverage exceeded two quadrants, and 52.71% of patients had lesions larger than 10 cm2. The average days in hospital of patients was 7.5 days, and 85.27% of them were satisfied with their post-surgery breast appearance. Within the median follow-up of 56 months, only 3.10% of patients experienced a recurrence of mastitis on the operation side. ConclusionThis novel surgical procedure we created is an effective treatment for RGM with a high success rate, high patient satisfaction, and low recurrence rate, and is significantly superior to other studies for it has the largest sample size and longest follow-up in this field.

The Role of Physical Therapy in Reducing the Recurrence of Clogged Milk Ducts and Subsequent Mastitis

Background: The World Health Organization supports and recognizes the benefits of breastfeeding, at least 6 months or more, for both a mother and her baby. A common cause for cessation of breastfeeding is the development of mastitis typically caused by a clogged milk duct. Literature is limited on physical therapy's role in reducing clogged milk ducts and subsequent mastitis. Study Design: A case report Case Description: This case describes a 33-year-old woman who was referred to physical therapy following unsuccessful treatment for breastfeeding complications that included daily bilateral clogged milk ducts and mastitis. The patient participated in a comprehensive physical therapy approach consisting of patient education, moist heat, therapeutic ultrasound, manual techniques, and cryotherapy. Outcomes: A retrospective review of 5 physical therapy visits over 3 weeks was completed. The patient reported no recurrence of mastitis and the ability to manage and decrease the recurrence of clogged milk ducts. The patient's number of daily clogged milk ducts and reported success with breastfeeding improved. At 6 months post-discharge, the patient reported she was able to continue breastfeeding and had no recurrence of mastitis. Discussion: Physical therapists may have a potential role in treating clogged milk ducts and subsequent mastitis in postpartum women where there is a lack of availability of lactation resources. A video abstract is available (see Supplemental Digital Content 1, available at: https://links.lww.com/JWHPT/A84).

Oral Lactobacillus fermentum CECT5716 in the patients with lactational abscess treated by needle aspiration: The late follow-up of a randomized controlled trial.

Background:Lactational mastitis and breast abscess cause trouble for women. It has been shown that oral probiotics can improve breast microecology, thus alleviating inflammatory responses. Our study aims to understand the long-term effect of Lactobacillus fermentum CECT5716 on patients with lactational breast abscess after needle aspiration.Methods:Data continued in a randomized controlled study of 101 subjects with lactational abscess from 12 hospitals were included. They were randomly divided into an experimental group and a control group. After needle aspiration treatment, the experimental group was orally administrated with L fermentum CECT5716 for 4 consecutive weeks, while the control group was treated with maltodextrin in the same way). In the third month after randomized controlled trial, the subjects were followed up by an online questionnaire investigation. The observation indexes included the relief of breast pain, recurrence of mastitis from the end of oral administration to the follow-up, and the effect on continuing breastfeeding.Results:A total of 101 patients were enrolled and 83 valid questionnaires were received during follow-up, including 40 in the experimental group and 43 in the control group. The rate of stop breastfeeding due to recurrence of mastitis was 2.5% (1/40) in the experimental group and 18.6% (8/43) in the control group, with a statistically significant difference (odds ratio = 0.112, 95% confidence interval: 0.013–0.942, P < .05). The rate of stop breastfeeding was 10% (4/40) in the experimental group and 25.6% (11/43) in the control group, without significant difference. The pain relief rate in the experimental group was 80% (32/40), which showed no significant difference from that in the control group, that is, 72.1% (31/43). The recurrence rate of mastitis in the experimental group was 20% (8/40), which was not significantly different from that in the control group, that is, 16.3% (7/43).Conclusions:In lactating women with a history of breast abscess, oral L fermentum CECT5716 may reduce the risk of stop breastfeeding due to recurrence of mastitis.

Risk Factors for Idiopathic Granulomatous Mastitis Recurrence after Patient-Tailored Treatment: Do We Need an Escalating Treatment Algorithm?

Objective: Idiopathic granulomatous mastitis (IGM) is a rare, relapsing, benign inflammatory breast disease. Due to the conflicting etiology and differential diagnosis, the effect of varied treatment regimens on high recurrence is controversial. Therefore, we aimed to report our clinical experience in determining risk factors for recurrence after patient-tailored treatment. Methods: This study evaluated 122 patients diagnosed with IGM according to sociodemographic characteristics, reproductive history, clinical presentation, time of diagnosis and radiological examinations, treatment management, and outcomes. The patients were classified into three groups based on curative treatment settings: medical therapy alone, surgery alone, and combined therapy. Results: The rates of patients receiving medical therapy alone, surgical therapy alone, and combined therapy were 23, 15.6, and 62.4%, respectively. Low vitamin B₁₂ levels, accompanying rheumatological disease, complaints-fistulae, number of complaints ≥3, presence of erythema nodosum, multicentricity, and treatment modality had a significant effect on disease recurrence (p < 0.05). The effect on IGM recurrence was 2.8 times greater for the patients with lower vitamin B₁₂ levels, 4.5 times greater for those with rheumatological disease, 3.3 times greater for those with fistulae, 2.4 times greater for those presenting with ≥3 complaints, 2 times greater for the presence of multicentricity, 2.3 times greater for the presence of erythema nodosum, and 4.5 times greater for the patients receiving medical therapy alone. Conclusion: Describing a low-risk patient profile can be an alternative while choosing monotherapy methods. For IGM patients at high risk of recurrence, an escalating treatment system may be effective in preventing relapses.

Interventions for preventing mastitis after childbirth.

Interventions for preventing mastitis after childbirth.

Correlation of age, education, employment status, parity and mastitis history with the incidence of mastitis

Background: The national coverage of exclusive breastmilk did not reach its target in 2014. One reason behind this was due to the swelling of the breast to mastitis condition. Hence the baby was not getting enough breastmilk. World Health Organization WHO estimates the mastitis case between 2.6 and 33 %, with global prevalence around 10% of all breastfeeding women. In 2014, Panembahan Senopati Bantul Yogyakarta Hospital documented 5.3% women with mastitis and 4.2% in 2015. Objective: This research aims to evaluate the correlation of ages, education, employment status, parity, and mastitis history with mastitis case in Panembahan Senopati Bantul Yogyakarta Hospital. Methods: This research was an observational analytic with a case-control design. Data analytic was performed using the Chi-Square test. Results: The results of bivariate analysis showed that age (OR = 0.673; 95% CI; 0.345-1.314), education (OR = 1.288; 95% CI; 0.678-2.44), employment status (OR = 1.368; 95% CI; 0.749 -2.497), and parity (OR = 0.829; CI 95%; 0.455-1.511) did not have a significant correlation with the incidence of mastitis, but the history of mastitis showed a significant association with the incidence of mastitis (OR = 2.280; 95% CI; 1.112-1.674 ). Conclusion: There was a correlation between the history of mastitis with the recurrence of mastitis in Panembahan Senopati Bantul Yogyakarta Hospital.

Invited review: Incidence, risk factors, and effects of clinical mastitis recurrence in dairy cows

Clinical mastitis (CM) is one of the most frequent and costly diseases in dairy cows. A frustrating aspect of CM is its recurrent nature. This review was conducted to synthesize knowledge on risk of repeated cases of CM, effects of recurrent CM cases, and risk factors for CM recurrence. A systematic review methodology was used to identify articles for this narrative review. Searches were performed to identify relevant scientific literature published after 1989 in English or French from 2 databases (PubMed and CAB Abstracts) and 1 search platform (Web of Science). Fifty-seven manuscripts were selected for qualitative synthesis according to the inclusion criteria. Among the 57 manuscripts selected in this review, a description of CM recurrence, its risk factors, and effects were investigated and reported in 33, 37, and 19 selected manuscripts, respectively. Meta-analysis and meta-regression analyses were used to compute risk ratio comparing risk of CM in cows that already had 1 CM event in the current lactation with risk of CM in healthy cows. For these analyses, 9 manuscripts that reported the total number of lactations followed and the number of lactations with ≤1 and ≤2 CM cases were used. When summarizing results from studies requiring ≥5 d between CM events to consider a CM event as a new case, we observed no significant change in CM susceptibility following a first CM case (risk ratio: 0.99; 95% confidence interval: 0.86-1.14). However, for studies using a more liberal CM recurrence definition (i.e., only 24 h between CM events to consider new CM cases), we observed a 1.54 times greater CM risk (95% confidence interval: 1.20-1.97) for cows that already had 1 CM event in the current lactation compared with healthy cows. The most important risk factors for CM recurrence were parity (i.e., higher risk in older cows), a higher milk production, pathogen species involved in the preceding case, and whether a bacteriological cure was observed following the preceding case. The most important effects of recurrent CM were the milk yield reduction following a recurrent CM case, which was reported to be similar to that of the first CM case, and the increased risk of culling and mortality, which were reported to surpass those of first CM cases.

Randomized, blinded, controlled clinical trial shows no benefit of homeopathic mastitis treatment in dairy cows

Mastitis is one of the most common diseases in dairy production, and homeopathic remedies have been used increasingly in recent years to treat it. Clinical trials evaluating homeopathy have often been criticized for their inadequate scientific approach. The objective of this triple-blind, randomized controlled trial was to assess the efficacy of homeopathic treatment in bovine clinical mastitis. The study was conducted on a conventionally managed dairy farm between June 2013 and May 2014. Dairy cows with acute mastitis were randomly allocated to homeopathy (n = 70) or placebo (n = 92), for a total of 162 animals. The homeopathic treatment was selected based on clinical symptoms but most commonly consisted of a combination of nosodes with Streptococcinum, Staphylococcinum, Pyrogenium, and Escherichia coli at a potency of 200c. Treatment was administered to cows in the homeopathy group at least once per day for an average of 5 d. The cows in the placebo group were treated similarly, using a placebo preparation instead (lactose globules without active ingredients). If necessary, we also used allopathic drugs (e.g., antibiotics, udder creams, and anti-inflammatory drugs) in both groups. We recorded data relating to the clinical signs of mastitis, treatment, time to recovery, milk yield, somatic cell count at first milk recording after mastitis, and culling. We observed cows for up to 200 d after clinical recovery. Base-level data did not differ between the homeopathy and placebo groups. Mastitis lasted for an average of 6 d in both groups. We observed no significant differences in time to recovery, somatic cell count, risk of clinical cure within 14 d after disease occurrence, mastitis recurrence risk, or culling risk. The results indicated no additional effect of homeopathic treatment compared with placebo. The advantages or disadvantages of homeopathy should be carefully assessed for individual farms.

대규모 젖소목장의 임상형 유방염 발생에 관한 후향적 연구

Incidence of mastitis is highest in dairy cows and it is a leader of all diseases and the economic losses, in dairy farms. The objective of this study is to analyse the incidence of clinical mastitis using the lactation number, lactation month and season of calving. In this study, we used 3,779 lactation data and animal health records collected from 1990 to 2006 at the National Institute of Animal Science. Out of 3,779 cows, a total of 1,721 cows were reported with clinical mastitis, which was 46.3%. The frequency of mastitis increased from 36.9% from first lactation to 56.0% by the fifth lactation. As many as 766 cows (46.9%) showed a recurrence of mastitis after 14 days, apart for two or more and chronic mastitis that were recorded for 657 cows (20.3%). This came to a total of 3,010 cases that had clinical mastitis in the herd for sixteen years. The distribution of incidence of clinical mastitis was highest during the first month of lactation at 24.4%, and it reached to 43.4% by the third month. The incidence of mastitis was even higher for cows in first lactation, showing 28.6% in the first month, and 42.9 percent by third month of lactation. Cows calved during the summer and winter months showed higher rate of incidence with 59.9% and 57.9% within 30 days of lactation, respectively. It is urgently needed to establish a preventative management for heifer cows during their expected first lactation and the clinical specific dry-period management strategies that influence the rate of clinical mastitis during the next lactation. The aim of this study is to present information that might be useful to improve clinical mastitis prevention.

Enfermedad de zuska. Diagnóstico en atención primaria

A fistula is an abnormal pathological communication which links two organs together or with the exterior. They are fibrous paths internally coated with granulation tissue, extending from an internal o primary opening to one or more openings located outside or on the skin. The recurrent mastitis that some patients suffer is due to a fistula between a lactiferous duct and the limit of the areola, and this condition is called a recurrent periareolar fistula.To incorporate this clinical condition into the proposed terminology, Zuska disease, is essential to believe in its existence, in order to to treat it from the source. The knowledge of this disease, a proper diagnosis and treatment will prevent the constant recurrence of mastitis as presented by these patients, avoiding their pilgrimage to various specialists. In this article we review this disease, methods of diagnosis and treatment.

The selective treatment of clinical mastitis based on on-farm culture results: I. Effects on antibiotic use, milk withholding time, and short-term clinical and bacteriological outcomes

The objective of this multi-state, multi-herd clinical trial was to evaluate the efficacy of using an on-farm culture system to guide strategic treatment decisions in cows with clinical mastitis. The study was conducted in 8 commercial dairy farms ranging in size from 144 to 1,795 cows from Minnesota, Wisconsin, and Ontario, Canada. A total of 422 cows affected with mild or moderate clinical mastitis in 449 quarters were randomly assigned to either (1) a positive-control treatment program or (2) an on-farm, culture-based treatment program. Quarter cases assigned to the positive-control group received immediate on-label intramammary treatment with cephapirin sodium. Quarters assigned to the culture-based treatment program were cultured on-farm and treated with cephapirin sodium after 18 to 24h of incubation if they had gram-positive growth or a mixed infection. Quarters with gram-negative or no growth did not receive intramammary therapy. The proportion of quarter cases assigned to positive-control and culture-based treatments that received intramammary antibiotic therapy because of study assignment was 100 and 44%, respectively; the proportion of cases that received secondary antibiotic therapy was 36 and 19%, respectively; and the proportion of cases that received intramammary antibiotic therapy because of study assignment or secondary therapy was 100 and 51%, respectively. A tendency existed for a decrease in the number of days in which milk was discarded from cows assigned to the culture-based treatment program versus cows assigned to the positive-control group (5.9 vs. 5.2 d). No statistically significant differences existed between cases assigned to the positive-control and cases assigned to the culture-based treatment program in days to clinical cure (2.7 vs. 3.2 d), bacteriological cure risk within 21 d of enrollment (71 vs. 60%), new intramammary infection risk within 21 d of enrollment (50 vs. 50%), and treatment failure risk (presence of infection, secondary treatment, clinical mastitis recurrence, or removal from herd within 21 d after enrollment; 81 vs. 78%). In summary, the use of an on-farm culture system to guide the strategic treatment of clinical mastitis reduced intramammary antibiotic use by half and tended to decrease milk withholding time by 1 d, without significant differences in days to clinical cure, bacteriological cure risk, new intramammary infection risk, and treatment failure risk within 21 d after the clinical mastitis event.

The selective treatment of clinical mastitis based on on-farm culture results: II. Effects on lactation performance, including clinical mastitis recurrence, somatic cell count, milk production, and cow survival

The objective of this multi-state, multi-herd clinical trial was to report on the efficacy of using an on-farm culture system to guide strategic treatment decisions in cows with clinical mastitis. The study was conducted in 8 commercial dairy farms ranging in size from 144 to 1,795 cows from Minnesota, Wisconsin, and Ontario, Canada. A total of 422 cows affected with mild or moderate clinical mastitis in 449 quarters were randomly assigned to either (1) a positive-control treatment program or (2) an on-farm culture-based treatment program. Quarter cases assigned to the positive-control group received immediate on-label intramammary treatment with cephapirin sodium. Quarters assigned to the culture-based treatment program were not treated until the results of on-farm culture were determined after 18 to 24h of incubation. Quarters in the culture-based treatment program that had gram-positive growth or a mixed infection were treated according to label instruction using intramammary cephapirin sodium. Quarters assigned to the culture-based treatment program that had gram-negative or no-growth did not receive intramammary therapy. It was already reported in a companion paper that the selective treatment of clinical mastitis based on on-farm culture results decreases antibiotic use by half and tends to decrease milk withholding time without affecting short-term clinical and bacteriological outcomes. The present article reports on long-term outcomes of the aforementioned study. No statistically significant differences existed between cases assigned to the positive-control program and cases assigned to the culture-based treatment program in risk and days for recurrence of clinical mastitis in the same quarter (35% and 78 d vs. 43% and 82 d), linear somatic cell count (4.2 vs. 4.4), daily milk production (30.0 vs. 30.7kg), and risk and days for culling or death events (28% and 160 d vs. 32% and 137 d) for the rest of the lactation after enrollment of the clinical mastitis case. In summary, the selective treatment of clinical mastitis based on on-farm culture resulted in no differences in long-term outcomes, such as recurrence of clinical mastitis in the same quarter, somatic cell count, milk production, and cow survival for the rest of the lactation after clinical mastitis.

Treatment of Infectious Mastitis during Lactation: Antibiotics versus Oral Administration of Lactobacilli Isolated from Breast Milk

Mastitis is a common infectious disease during lactation, and the main etiological agents are staphylococci, streptococci, and/or corynebacteria. The efficacy of oral administration of Lactobacillus fermentum CECT5716 or Lactobacillus salivarius CECT5713, two lactobacilli strains isolated from breast milk, to treat lactational mastitis was evaluated and was compared with the efficacy of antibiotic therapy. In this study, 352 women with infectious mastitis were randomly assigned to 3 groups. Women in groups A (n = 124) and B (n = 127]) ingested daily 9 log(10) colony-forming units (CFU) of L. fermentum CECT5716 or L. salivarius CECT5713, respectively, for 3 weeks, whereas those in group C (n =101) received the antibiotic therapy prescribed in their respective primary care centers. Results. On day 0, the mean bacterial counts in milk samples of the 3 groups were similar (4.35-4.47 log(10) CFU/mL), and lactobacilli could not be detected. On day 21, the mean bacterial counts in the probiotic groups (2.61 and 2.33 log(10) CFU/mL) were lower than that of the control group (3.28 log(10) CFU/mL). L. fermentum CECT5716 and L. salivarius CECT5713 were isolated from the milk samples of women in the probiotic groups A and B, respectively. Women assigned to the probiotic groups improved more and had lower recurrence of mastitis than those assigned to the antibiotic group. Conclusions. The use of L. fermentum CECT5716 or L. salivarius CECT5713 appears to be an efficient alternative to the use of commonly prescribed antibiotics for the treatment of infectious mastitis during lactation. ClinicalTrials.gov identifier. NCT00716183.

Methicillin-Resistant Staphylococcus aureus Infections May Not Impede the Success of Ultrasound-Guided Drainage of Puerperal Breast Abscesses

Ultrasound-guided percutaneous drainage has been suggested in recent years to be the treatment of choice for breast abscesses. Although MRSA has recently been observed to be a significant causative pathogen in mastitis, reports dealing with ultrasound-guided drainage of breast abscess did not address the bacteriology of these infections. Between January 1 and December 31, 2007, 129 women were diagnosed with puerperal mastitis at Taipei City Hospital. Data were collected by retrospective chart review. Charts were surveyed for mastitis recurrence for at least 1 year after the initial infection treatment, through December 31, 2008. The most commonly identified organism was Staphylococcus aureus, present in 69 of 78 of bacterial isolates (88%). There were 52 of 78 (66%) bacterial isolates that were MRSA. Forty-seven of 52 (90%) women infected by MRSA underwent initial ultrasound-guided percutaneous abscess drainage. Among them, 11 (23%) women underwent subsequent conversion to surgical incision and drainage. Comparing women infected with MRSA and women infected with other pathogens, there was no statistical difference in the duration of treatment, number of outpatient follow-up visits, duration of antibiotics use, or abscess recurrence rates. MRSA is the most common bacteria in puerperal breast abscess in our population. When these patients are treated initially by percutaneous abscess drainage followed by repeated ultrasound-guided drainage or surgical incision and drainage, the presence of MRSA may not adversely affect treatment outcomes.

Effect of the Treatment of Clinical Mastitis Based on On-farm Culture on Secondary Therapy, Days to Clinical Cure, Days out of Tank, Mastitis Recurrence, Somatic Cell Count, Milk Yield, and Culling

Lago et al (2008) reported that the adoption of an on-farm culture (OFC) system to guide strategic treatment decisions resulted in a reduction in antibiotic use, but no decrease in bacteriological cure risk for mild or moderate cases of clinical mastitis (CM). The objective of this abstract is to describe the effect of the aforementioned treatment program on other short and long term outcomes after CM.

Relationship between in vitro susceptibility test results and treatment outcomes for gram-positive mastitis pathogens following treatment with cephapirin sodium

The selection of antimicrobial agents for the treatment of mastitis has often been based on results of in vitro susceptibility testing. However, the results of in vitro susceptibility tests have been shown to be poor predictors of treatment outcomes. The objective of this study was to determine if an association existed between results of antimicrobial susceptibility tests and outcomes of mastitis caused by gram-positive pathogens recovered from quarters that received treatment with cephapirin sodium. Mastitis pathogens were obtained from a multi-site clinical trial that evaluated the benefits of using an on-farm culturing system. Target pathogens (n = 187) comprised coagulase-negative staphylocci (65%), Streptococcus spp. (14%), other pathogens (12%), and Staphylococcus aureus (11%), which were recovered from quarters that received treatment using cephapirin sodium. The antimicrobial susceptibility profile to cephapirin was determined using the broth micro-dilution technique. The overall bacteriological cure rate achieved by cephapirin treatment was 82%. Bacteriological outcomes (cure or treatment failure) were not associated with pathogen type. A recurrent case of mastitis was observed in 10 quarters classified as cures and 3 quarters classified as treatment failures. Recurrence of mastitis was not associated with bacteriological outcomes or susceptibility test results. In vitro susceptibility to cephapirin was exhibited by 94.8 and 91.2% of pathogens recovered from quarters classified as cures and treatment failures, respectively. Bacteriological outcomes of mastitis treated using cephapirin were not associated with in vitro susceptibility test results or in vitro minimum inhibitory concentration values. In this population, there was an 82% probability of treatment success when the isolate was susceptible but only a 27% probability of treatment failure when the isolate was resistant. Based on this research, results of in vitro susceptibility tests should not be used as the primary guide for treatment decisions regarding intramammary cephapirin sodium.

Short Communication: Efficacy of Parenteral Ceftiofur for Treatment of Systemically Mild Clinical Mastitis in Dairy Cattle

The objective of this study was to evaluate the effect of intramuscular (i.m.) ceftiofur (2.2mg/kg) on important outcomes of systemically mild clinical mastitis episodes in lactating dairy cattle. Cows with clinical mastitis were randomly assigned to a treatment group: pirlimycin intramammary (i.m.m.) (n=35), pirlimycin i.m.m. and ceftiofur i.m.m. (n=36), cephapirin i.m.m. (n=40), cephapirin i.m. and ceftiofur i.m. (n=33). Sixty-nine, 22, and 9% of initial cultures were gram-negative, gram-positive, and mixed, respectively. Logistic regression analysis showed no significant associations between treatment groups and loss of quarter, recurrence, or culling. Mixed infections, positive milk culture at 7 d after leaving hospital pen, decreased rumen motility, and absence of udder firmness were associated with increased odds of mastitis recurrence. The results suggest that i.m. ceftiofur treatment has no beneficial effects on the outcome of systemically mild clinical mastitis.

Lactation mastitis: a descriptive study of the experience.

This descriptive study of 31 women diagnosed with lactation mastitis in the midwestern United States investigated mastitis symptomatology, self-care and treatment, burden of mastitis, and symptom recurrence and complications. Data collected via telephone interviews soon after diagnosis and daily through the seventh day after symptom onset documented that symptom intensity was moderate, peaked on the second day, and lasted on average 3 to 4 days. Symptoms had greater impact on activities of daily living than on breastfeeding. Sources of advice for self-care included lactation consultants, nurses, nurse practitioners, physicians, family, and friends. Continued breastfeeding was the most frequently used of several self-care practices and was rated as highly effective. Follow-up at 2 and 6 weeks established mastitis recurrence as the most common complication. Breastfeeding women need specific information about mastitis causes, symptoms, and self-care strategies to help prevent and treat the condition.

Mastitis in the first year postpartum.

Limited information is available about the frequency and risk factors for lactation mastitis. The purpose of this study was to investigate frequency, risk factors, and outcome for lactation mastitis. We analyzed data from a cohort study of 350 mothers with healthy term infants, who were followed up for one year postpartum. Eighty-three women (23.7% of the sample) reported one or more episodes of mastitis symptoms, and 61 (17.4%) women reported symptoms including fever. Fifty-six women (16%) received one or more courses of antibiotics for mastitis. Thirty women (8.5%) of the total cohort had recurrent episodes of mastitis symptoms. A total of 123 episodes of mastitis symptoms were reported. No cases of abscess were reported. Using multiple logistic regression, the adjusted risk ratio for mastitis symptoms associated with sore nipples in the first month was 2.07 (95% CI = 1.17, 3.66). A reduced risk of mastitis was associated with maternal smoking during pregnancy, with supplementation with water in the first month, and with the use of a pacifier on a daily basis within the first month. A history of mastitis symptoms was associated with a longer overall duration of breastfeeding. Our results suggest that mastitis may be a marker for an ample milk supply. Mothers presenting with mastitis can be reassured that the outlook for continued successful lactation is good. Further research is needed to investigate the reasons for recurrence of mastitis and the etiology of episodes occurring late in lactation.