Infected nipple - could it heal without more antibiotics?

[LakeFlyPie]

About 6 weeks ago i got a small puncture wound on areola from DS2 extremely sharp new tooth (he didn't bite, it just rubbed when he was bf).
It got very red and sore so I saw GP and got a 5 day course of flucloxacillin which seemed to sort it out
A fortnight or so later it swelled and when I poked pus came out so I saw emergency GP (it was BH weekend) and got a further 7 day course of fluclox.
It seemed to heal again.
There has been a small lump which I presumed would settle down with further healing time.
It's now a fortnight later and today it was very tender when I bf on that side and this evening I felt a pop and a bit more pus came out.
I've been bf DS with holding him facing the opposite way on that side IYSWIM so his new tooth isn't in contact with the 'wound'
I haven't got temps and wondered if there's any chance it'll heal on it's own if so is there anything I can do to promote healing?
Or is it back to GP for more antibiotics?
TIA (and sorry for TMI pus content!)

Has the actual bacteria causing the infection been identified? As in swabs done or samples taken.

There's no point you having course after course of flucloxacillin if it isn't actually effective against the bacteria....I know the Drs will have judged that Flucloxacillin is going to get rid of the likeliest candidate but if it isn't getting rid of it a different (perhaps more specific) anti-biotic needs to be tried.

Hope you get a resolution soon.

Thanks for your reply Truthsweet, I did wonder about swabs.

It has looked as if it's almost healed both times on the fluclox but then has flared up again a week or so later. It does seem that there's some infection lurking under the almost healed wound.
DS bf during night when I'm not very vigilant about positioning asleep so think he may be preventing complete healing.
I know the fluclox is chosen partly because it's OK with bf, not sure what other options there are.
Will try and book in with GP again this week.

This is the Breastfeeding Network's fact sheet on Anti-biotics and bfing (written by Wendy Jones who is a pharmacist and a Breastfeeding Counsellor).

Hope that helps!

An update:
Did a wound swab at work (hospital) and saw GP who restarted fluclox yesterday.

Was contacted (in rather an alarmingly speedy way) by microbiology lab to say they have cultured beta haemolytic strep. They had already contacted my GP who has spoken to the lab and says the fluclox is an appropriate antibiotic but I should extend the course.
Have also been told not to have any patient contact until 48 hours on antibiotics
Wound feels much better and no more pus evident (wish I hadn't googled and seen the words necrotising fasciitis ) so hopefully this will sort it out for good.

LakeFlyPie,

I'm sorry it's a strep. infection BUT at least they know what it is and they can treat with targeted anti-bs.

I hope this course of Fluclox works (is it a higher dose/longer course?) and you heal quickly.

Have they given you any advice about bfing on the injured side? Or wound care?

Thanks Truthsweet

Yes, they've recommended a longer course of fluclox.
No advice about bf on injured side or wound care.

GP is generally very good but not a great supporter of extended bf IME.
He was a bit when I said that DS2 is 17mos and still bf so I didn't go on to explain my strategy of giving the injured side to DS1 (who's 4 next month) for his bed time bf as I can explain to him to be gentle.
DS2 is limited to the other side until it's completely healed as I think his sharp new fang was causing irritation.

Am a bit twitched at the alarm bells that seemed to ring at work when the lab cultured the strep as phone calls seemed to be made in an extremely efficient manner and I've been told not to have patient contact and that I have to see occupational health ASAP.
I was asked if the wound was covered , err yes I don't usually go topless at work.
Think I'll ask occ health if I need a referral to a wound care nurse just to be on the safe side.

I'm not doing any more googling, will wait and ask real life medical professionals for some more info tomorrow.

So you don't work at the strip club/A&E dept then? Or is that just a new initiative at my local A&E dept....

If Occ Health could get you a wound care nurse to assist in healing that would be fantastic, they might also tell you how infectious it is and how it can be transmitted (Assuming it's contact but it might be mitigated by the anti-microbial factors in BM I don't know).

It does sound like a good plan to ask your DS1 to nurse on the wounded side. I think older bfing children are more understanding of their world and that their actions can have repercussions. I can remember DD1 apologising for making me gasp when I was a few weeks pg with DD3 and I was so sore - I assured her it wasn't her fault of course and that she could nurse when she needed it (she was about to turn 3 then).

PS if you keep googling you WILL find out you are about to die of bubonic plague and you are the 100,000 visitor to the site so have won an iPad. Win win all round