A Cochrane review [Abstract] 1 included 2 studies with a total of 238 subjects. One small trial (n = 25) compared amoxicillin with cephradine and found no significant difference between the two antibiotics in terms of symptom relief and abscess formation. Another, low quality study compared breast emptying alone as "supportive therapy" vs antibiotic therapy plus supportive therapy, and no therapy. The findings of the latter study suggested faster clearance of symptoms for women using antibiotics.
In a prospective study 2 to assess the contributing factors in puerperal breast abscess 128 lactating women with breast infection were followed. Of these, 102 had mastitis (80%) and 26 had breast abscess (20%). All mastitis patients were treated with antibiotics and none developed an abscess. Duration of symptoms and healing were longer in cases of abscess. Multivariate analyses showed that duration of symptoms was the only independent variable for abscess development.
Comment: The quality of evidence is downgraded by inconsistency by indirectness (no placebo in the comparison), by imprecise results (limited study size for each comparison), and by potential reporting bias (only few small trials reported).
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