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Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Mastitis is a common reason new mothers visit their general practitioner (GP). In Australia, the <jats:italic>Therapeutic Guidelines: Antibiotic<\/jats:italic> provides practical advice to GPs managing a range of infections, including mastitis. It is not known if Australian GPs prescribe antibiotics and order investigations as recommended for the management of mastitis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A convergent mixed methods design integrated quantitative analysis of a general practice dataset with analysis of interviews with GPs. Using the large-scale primary care dataset, MedicineInsight, (2021\u20132022), antibiotics prescribed and investigations ordered for mastitis encounters were extracted. Mastitis encounters were identified by searching \u2018Encounter reason\u2019, \u2018Test reason\u2019 and \u2018Prescription reason\u2019 free text field for the term \u2018mastitis\u2019; \u2018granulomatous mastitis\u2019 was excluded. Clinical encounters for mastitis occurring within 14 days of a previous mastitis encounter were defined as belonging to the same treatment episode. Semi-structured interviews were conducted with 14 Australian GPs using Zoom or telephone in 2021\u20132022, and analysed thematically. The Pillar Integration Process was used to develop a joint display table; qualitative codes and themes were matched with the quantitative items to illustrate similarities\/contrasts in findings.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>During an encounter for mastitis, 3122 (91.7%) women received a prescription for an oral antibiotic; most commonly di\/flucloxacillin ([59.4%]) or cefalexin (937 [27.5%]). Investigations recorded ultrasound in 303 (8.9%), blood tests (full blood examination [FBE]: 170 [5.0%]; C-reactive protein [CRP]: 71 [2.1%]; erythrocyte sedimentation rate [ESR]: 34 [1.0%]) and breast milk or nipple swab cultures in approximately 1% of encounters. Analysis using pillar integration showed consistency between quantitative and qualitative data regarding mastitis management. The following themes were identified:<\/jats:p>\n                <jats:p>- GPs support continued breastfeeding.<\/jats:p>\n                <jats:p>- Antibiotics are central to GPs' management.<\/jats:p>\n                <jats:p>- Antibiotics are mostly prescribed according to <jats:italic>Therapeutic Guidelines.<\/jats:italic><\/jats:p>\n                <jats:p>- Analgesia is a gap in the <jats:italic>Therapeutic Guidelines.<\/jats:italic><\/jats:p>\n                <jats:p>- Low use of breast milk culture.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Prescribing antibiotics for mastitis remains central to Australian GPs\u2019 management of mastitis. Interview data clarified that GPs were aware that antibiotics might not be needed in all cases of mastitis and that delayed prescribing was not uncommon. Overall, GPs followed principles of antibiotic stewardship, however there is a need to train GPs about when to consider ordering investigations.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12875-024-02414-4","type":"journal-article","created":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T09:03:08Z","timestamp":1715331788000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["General practitioners\u2019 management of mastitis in breastfeeding women: a mixed method study in Australia"],"prefix":"10.1186","volume":"25","author":[{"given":"Lisa H.","family":"Amir","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharinne B.","family":"Crawford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meabh","family":"Cullinane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke E.","family":"Grzeskowiak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,10]]},"reference":[{"issue":"9","key":"2414_CR1","first-page":"745","volume":"35","author":"LH Amir","year":"2006","unstructured":"Amir LH, Lumley J. 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The independent MedicineInsight Data Governance Committee approved the quantitative component (protocol 2019\u2013003) and the Human Research Ethics Committee of the University of Adelaide and La Trobe University exempted it from ethical review due to the use of non-identifiable data.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"161"}}