Hoping that you are all very well, I greet you. I wish you all happy days with your loved ones in these last days of this year 2022.
But, this publication is not only to greet you, but I would very much like to leave some information about an experience I had yesterday, a day of much work, but I ended the day with a case of a woman in puerperium, that is, that period after childbirth, from the first day until day 365. This woman in question has 6 weeks of having given birth to a girl, who is healthy, but the mother for economic reasons has had some problems since the first week of puerperium, and has not been able to solve.
This post is not related to the economy, but to a topic that I have been developing for some days, which has to do with the Bacterial Resistance and how this is "promoted or driven" by mismanagement of antibiotics. And not only for that, there are other causes that I particularly consider should be given special attention and are very well described by my friend 
In this post I will try to link two topics, on the one hand the problem presented by the mother, a mastitis, and how the ineffective treatment with antibiotics has made her problem last for a long time.
Before continuing, it is necessary to be clear what Mastitis is, and this is an inflammation of the mammary gland that can occur in women who are breastfeeding. The most common cause of mastitis is obstruction of the milk ducts in the breast, which can be caused by the milk not emptying completely during lactation or by compression of the milk duct during lactation. It can also occur when milk becomes trapped in the milk duct due to a blockage or because the baby is not sucking properly.
These causes I have mentioned are the most common. In the case of the mother in question, she stopped breastfeeding because the baby hurt her nipples, and because of this, as the mammary glands did not empty, they became clogged, and subsequently infected, resulting in much worse pain.
Of course, these are not the only causes of mastitis, I would also like to mention:
Bacterial infection: Mastitis can be caused by a bacterial infection that spreads to the mammary gland through the milk duct.
Trauma or damage to the breast: Any type of damage or trauma to the breast, such as a cut or burn, can cause mastitis.
Stress or fatigue: Stress and fatigue can weaken the immune system and make you more prone to developing infections, including mastitis.
As you may realize, an infection can also cause it, or be started by a blockage and subsequent infection.
Generally, to a breastfeeding mother, and considering that the child is only a few weeks old, a type of antibiotic that will not affect the baby is indicated when there is a case of infection and mastitis, in addition to an anti-inflammatory analgesic such as ibuprofen.
The most commonly used antibiotics are Sulbactan Ampicillin and Amoxicillin with clavulanic acid. In the first case it can be prescribed every 8 or 12 hours, for 7 to 10 days, and in her case it was prescribed for 10 days, every 12 hours.
If she had fully complied with her treatment, she would not have had any additional problems and surely in a few days after completing her complete treatment, she would have had a total improvement. But (and this is where the economic problem for her comes in), she could not buy the treatment for the full days because she did not have the money to buy it, and she only took it for 5 days.
She improved slightly, and she thought that with 5 days she would be fine. So she did not continue with the treatment, and after about 10 days the pain and infection process was worse than at the beginning.
I got all this information by talking to her yesterday. The problem I want to highlight here is that it is no longer logical for her to start treatment with the same drug, since it is quite likely that there is bacterial resistance, since she presented the antibiotic to the bacteria they have in the breast, it did not kill them all, since she did not comply as she should the treatment, which implies that the treatment should be rotated for a new one.
This has meant that she has not been able to breastfeed the baby because of the severe pain involved, plus she has an infection and it is not convenient for the baby to stick to the teat in that condition. But the baby has to eat, obviously, and she has started to give her some of those formula milk, but this has not been medicated either, it has been on her own, which has caused the little girl to suffer from constipation.
And if the mom and dad couldn't get money for the treatment, now they have to get money to buy the formulas for the baby, which by the way is hurting her. It has been a chain of events, which has complicated the situation for both of them.
It is a complex case to deal with, because it is not only a woman with mastitis, but she is in the process of breastfeeding a small baby, who is already presenting gastrointestinal problems due to the intake of milk formulas.
And it is not only the lack of compliance, but there is a lack of economic resources that limit her to be able to comply with what she needs, to heal quickly and avoid complications for the baby.
The cause of the problem is diverse, but the consequences are also varied. One of them, as an example, is how bacterial resistance is created in this case by non-compliance with treatment. It is common to see how people do not comply with antibiotic treatments, despite having the resources to buy it, just because they feel well on the fourth or fifth day, and then the infection reappears and with greater resistance.
I hope this publication has been to your liking. Thank you very much for reading it.
