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Table 2 Suggestions for antimicrobial treatment of clinical mastitis due to different pathogens. The availability of substance on the market mentioned in the table may differ between countries

From: Treatment of mastitis during lactation

Micro-organism Species Drug of choice Alternative Comments
Streptococci Streptococcus agalactiae
Streptococcus dysgalactiae
Streptococcus uberis
Penicillin G   IMM treatment preferable.
  Enterococci According to susceptibility testing   Prognosis for bacteriological cure is poor
Staphylococci Staphylococcus aureus
Coagulase negative staphylococci
β-lactamase -ve
Penicillin G   Combination treatment in S. aureus mastitis
  Staphylococcus aureus
Coagulase negative staphylococci
β-lactamase +ve
No antimicrobials Cloxacillin Macrolides Lincosamides IMM and/or systemic treatment depending on the drug used. Prognosis for S. aureus mastitis is poor. Cloxacillin may select for methicillin-resistant
Coliforms Escherichia coli Klebsiella spp. No antimicrobials Fluoroquinolones Cephalosporins Antimicrobials necessary in serious cases and during puerperal period