Women’s Health
An assessment of antibiotic treatment failure burden among lactational mastitis patients by initial antibiotic prescription and demographic characteristics Ruchir Raman* Ruchir Raman Raman Raman Raman Raman Raman Indiana University School of Public Health Bloomington
Background and Justification: Lactational mastitis is an inflammatory breast disease associated with significant maternal morbidity. Its incidence varies from 2.5-20% in breastfeeding mothers, however these rates are generally thought to be underestimated. Antibiotics have been recommended for treatment of lactational mastitis, particularly in cases where infection is persistent and unable to self-resolve. However, there is a lack of comparative effectiveness studies of the different types of antibiotics prescribed for lactational mastitis treatment. To this purpose, we aim to assess treatment failure burden among lactational mastitis patients by the type of antibiotic first prescribed and by other demographic factors.
Methods: We used data from the Merative MarketScan database from January 1, 2016 – December 31, 2023 for our analysis. All patients < 49 years old with an incident diagnosis of lactational mastitis identified by ICD-10 codes N61.0 (mastitis without abscess), O91.1x (abscess of breast associated with pregnancy, puerperium or lactation) and O91.2x (nonpurulent mastitis associated with pregnancy, puerperium or lactation) and a documented care encounter with a physician in an outpatient setting were included. Treatment failure was defined as a binary outcome when a patient initiated a second prescription that was different the initial prescription. We assessed treatment failure on two time scales, within 72 hours and within . Antibiotic prescription and demographic covariate details were obtained from MarketScan.
Results: We found 65,243 lactational mastitis patients, of which 51,231 (78.5%) were prescribed an antibiotic. In patients with > 1 prescription, the median time between initial and next prescription fill was 8 days (IQR: 3-15 days). A comprehensive analysis of the antibiotic prescription, treatment failure burden, and other demographic characteristics of lactational mastitis patients is currently underway.