Prevention of infectious mastitis by oral administration of Lactobacillus salivarius PS2 during late pregnancy
Reviewer: Alan Gaby, MD
Author: Fernandez L, et al
Reference: Prevention of infectious mastitis by oral administration of Lactobacillus salivarius PS2 during late pregnancy. Clin Infect Dis 2016;62:568-573.
Design: Randomized, double-blind, placebo-controlled trial.
Participants: One hundred eight pregnant women who had experienced infectious mastitis after a previous pregnancy.
Study Medication and Dosage: A probiotic preparation (Lactobacillus salivarius PS2; 9 log10 colony-forming units once a day) or placebo, from about 30 weeks of gestation until delivery.
Primary Outcome Measure: Occurrence of infectious mastitis.
Key Findings: The proportion of women who developed infectious mastitis during the first 3 months after delivery was significantly lower in the probiotic group than in the placebo group (25% vs. 57%; p = 0.001). When mastitis occurred, the milk bacterial counts were significantly lower in the probiotic group than in the placebo group.
Practice Implications: Mastitis is a common problem in breastfeeding women. It is frequently caused by an infection with Staphylococcus aureus or other bacteria. Conventional treatment includes antibiotics, pain medication, hot packs before feeding, and cold packs after feeding. The results of the present study indicate that administration of L. salivarius PS2 during late pregnancy can decrease the incidence and severity of infectious mastitis in women who have suffered from this problem in a previous pregnancy. Further research is needed to determine whether other probiotic strains would have a similar effect.