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Women’s Health

Do antibiotics help reduce hospitalizations among mastitis patients over time? Ruchir Raman* Ruchir Raman Dr Christina Ludema Ashley Judge

Background and Justification: Lactation mastitis is an inflammatory breast disease which is associated with significant maternal morbidity. The incidence of lactation mastitis has been estimated to vary between 2.5-20% in breastfeeding mothers, however these rates are generally thought to be underestimated. In a small number of cases, mastitis can progress to sepsis, a very serious condition that usually requires hospitalization and treatment with intravenous antibiotics. While progression to sepsis is likely influenced by the strain of bacteria and the immune response of the individual, initial prescription of antibiotics may also influence later hospitalization. To this purpose, the current investigation aims to characterize the longitudinal association between antibiotic use among mothers with lactation mastitis and hospitalizations and whether this association is affected by socioeconomic (SES) determinants.

A cohort was constructed using claims data using sociodemographic, antibiotic use and hospitalization data available through the Optum Clinformatics Data Mart. Patients with lactation mastitis diagnosis in the dataset were identified through the ICD-10 codes O91.13 (abscesses of breast associated with lactation) and O91.23 (nonpurulent mastitis associated with lactation). Patients were followed up to check if they had any hospitalization for sepsis in the twelve months following the diagnosis. Categorical versions of the variables of interest were created, with frequencies (N) and corresponding percentages (%) tabulated at baseline.

Results: Observations for 7648 mothers with incident mastitis diagnoses have been obtained. At baseline, the population of mothers with mastitis is mostly white (5042, 65.9%), high income >=US$100K (3465, 45.3%), and have an education level of lesser than a bachelor’s degree equivalent (3751, 57.1%). A longitudinal analysis of the data is currently underway.