Final answer:
Severe infection with a breast abscess showing systemic instability typically requires surgical drainage and intravenous antibiotics (e.g. penicillin G, clindamycin). Supportive care for organ systems and hemodynamic support are also important in the management.
Step-by-step explanation:
The management of a severe infection with breast abscess that includes hemodynamic instability and progressive erythema typically requires aggressive treatment beyond what can be achieved with oral antibiotics or topical antiseptics alone. Surgical drainage is often necessary to remove the infected material and is considered a standard intervention alongside antibiotic therapy, which may need to be intravenous because of the severity. Conditions like necrotizing fasciitis or gas gangrene may present with rapid progression and require not only antibiotics, such as penicillin G and clindamycin, but also immediate surgical intervention. Situations with systemic involvement, such as septic shock or organ failure, necessitate additional supportive care measures, including fluids and medications to support blood pressure and prevent clotting, as indicated by the case of a patient with a CRE infection treated with tigecycline.