Livingstone 1999.

Study characteristics
Methods	Design: prospective, randomised clinical trial. This study trial led basic breastfeeding advice with a combination of antibiotics and topical ointments. Setting: Canada, Vancouver Breastfeeding Center
Participants	Number of participants: (N = 84) Inclusion criteria: (N = 84). postpartum breastfeeding women with sore or cracked nipples. Mothers attending breastfeeding clinic for breastfeeding problems, cracked/sore nipples, positive Staphyloccocus aureus results Exclusion criteria: mothers with local or system spread of infection such as cellulitis, ascending lactiferous duct infection or mastitis
Interventions	Interventions: 4 intervention groups: 1. Optimal breastfeeding technique (basic breastfeeding advice) (N = 23) 2. Topical 2% mupirocin ointment to nipples, (N = 25) 3. Topical fusidic acid ointment to nipples, (N = 17) 4. Oral antibiotics ‐ cloxacillin/erythromycin, (N = 19)
Outcomes	Measured nipple symptoms, breast symptoms and mastitis
Notes	100% compliance ‐ highly‐motivated breastfeeding women Intention‐to‐treat not used This study was stopped prematurely ‐ women who did not receive antibiotics perceived to have a higher rate of mastitis Authors contacted July 2020 to clarify study dates and declarations of interest; email address no longer active Dates of study: not stated Funding sources: funding in part was supported by the Department of Family Practice, Vancouver General Hospital. Berkowitz associates provided statistical consultation.  Declarations of interest: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	100 tags were alternatively labelled A, B, C, D and placed in an envelope.
Allocation concealment (selection bias)	Low risk	Each case randomly assigned by drawing a tag from the envelope
Blinding of participants and personnel (performance bias) All outcomes	High risk	"This was an open study and outcome measures could be subjected to bias". Lack of blinding could influence women's and caregivers' perception of symptoms.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not specifically reported if outcome assessors were blinded (i.e. we did not know if people recording women's and caregivers' perception of symptoms were blinded)
Incomplete outcome data (attrition bias) All outcomes	Low risk	No losses reported
Selective reporting (reporting bias)	Low risk	Protocol publication was not common practice at the time but there was nothing to indicate selective reporting.
Other bias	Low risk	Nothing to indicate any other source of bias