The clinial utility of serum leukocyte counts for initial antibiotic use
in acute mastitis: the experience from China
Abstract
Abstract Objectives: This study aimed to evaluate the clinical utility
of serum leukocyte counts (SLCs) for initial antibiotic use in Chinese
women with mastitis who presented to the emergency department. Materials
and Methods: Electronic medical records of breastfeeding women with
mastitis were reviewed. Patients were divided into two groups according
to the level of SLCs: slight elevated leukocyte counts (SELC,
1.0-1.5*10^9 cells/L); marked elevated leukocyte counts (MELC,
>1.5*10^9 cells/L ). Treatment outcomes including rates
of treatment failure and breast abscess formation were compared.
Results: The rates of treatment failure and breast abscess were 12.7%
and 7.1% in overall population and 7.7% and 6.4% in MELC group,
respectively. In SELC group, treatment failures were observed in 29.7%
and 6.4% patients without or with antibiotics, and the difference was
significant (OR=4.207, 95% CI 1.318- 13.424); breast abscess was
observed in 12.5% and 2.1% patients, and the difference was not
significant (OR=6.571, 95% CI 0.793-54.481). Mean time to normal
appearance of the breast or normal temperature was shorter in patients
with antibiotics (3.8 ± 1.7 and 4.3 ± 2.1 days) than in patients without
antibiotic use (2.5 ± 1.1 and 3.0 ± 1.3 days), p<0.001.
Conclusion: Our study found that there were better clinical outcomes in
patients with SELC or MELC when antibiotic was initially administrated
compared to those without antibiotics, whicha indicates that SLC is an
easy and practical reference index for gudiing antibiotic use, and
patients who have an elevated SLC should be treated with antibiotic. Key
Words: mastitis, antibiotic, serum leukocyte count