探讨哺乳期乳腺脓肿常规使用抗生素治疗的必要性。

回顾性分析2017年1~12月广州市妇女儿童医疗中心诊治的哺乳期乳腺脓肿患者的临床资料。其中未使用抗生素治疗者50例(对照组)，使用抗生素治疗者106例，并采用简单随机抽样方法从106例患者中选取50例(抗生素组)进行对照分析。观察治愈时间、回乳率、复发率、脓液细菌培养等相关指标，其中组间治愈时间比较采用独立样本t检验，回乳率及复发率的比较采用χ²检验。

所有入组患者均达到临床治愈指征后出院。抗生素组与对照组患者的治愈时间分别为(6.3±3.3)d和(5.7±2.3) d，两者比较，差异无统计学意义(t＝1.063，P＝0.291)。抗生素组与对照组患者相比，回乳率和复发率的差异均无统计学意义[48%(24/50)比36% (18/50)，P＝0.224；6%(3/50)比8%(4/50)，P＝1.000]。2组的耐甲氧西林金黄色葡萄球菌(MRSA)占比均为28% (14/50)。

哺乳期乳腺脓肿常规使用抗生素治疗证据不足，需要进一步筛选抗生素使用的指征。

To investigate the necessity of routine antibiotic treatment for lactational breast abscess.

The clinical data of patients with lactational breast abscess in the Guangzhou Women and Children’s Medical Center from January to December 2017 were retrospectively analyzed. A total of 106 cases were treated with antibiotics, in which 50 cases were enrolled through simple random sampling as antibiotic group. Fifty patients who received no antibiotics served as control group. The healing time, weaning rate, recurrence rate and bacteria culture results were recorded in both groups. The independent sample t test was used to compare the healing time between two groups. χ² test was used to compare the weaning rate, and recurrence rate between two groups.

All enrolled patients were discharged after they met the criteria of clinical healing. The healing time was (6.3±3.3) d in antibiotic group and (5.7±2.3) d in control group, indicating no significant difference (t=1.063, P= 0.291). The weaning rate and recurrence rate demonstrated no significant difference between antibiotic group and control group [48%(24/50) vs 36% (18/50), P=0.224; 6%(3/50) vs 8%(4/50), P=1.000]. The proportion of MRSA infection was 28%(14/50) in both groups.

There is insufficient evidence to support routine use of antibiotics for lactational breast abscess and further screening of indications is necessary