Because many antibiotics are excreted into the breast milk, it can be difficult for a practitioner to choose an antibiotic for a lactating patient that will have minimal risks to her nursing infant. This article is the first of a three-part series discussing the use of anti-infective agents during lactation. The authors review general information regarding use and common side effects of several classes of antibiotics. They also summarize information, including documented milk concentrations, milk-to-plasma ratios, and other pharmacokinetic properties, in a table that can help practitioners choose antibiotics that may be considered safe for the lactating mother.
Dillon AE, Wagner CL, Wiest D, Newman RB. Drug therapy in the nursing mother. Obstet Gynecol Clin N Am. 1997;24:675-696.
4.
Wright AJ. Symposium on antimicrobial agents. Part VI: The penicillins. Mayo Clin Proc. 1999;74:290-307.
5.
Marshall WF, Blair JE. Symposium on antimicrobial agents. Part V: The cephalosporins. Mayo Clin Proc. 1999;74:187-195.
6.
Guglielmo BJ. Principles of infectious diseases. In: Young LY, Koda-Kimble MA, eds. Applied Therapeutics: The Clinical Use of Drugs. 6th ed.Vancouver, Canada: Applied Therapeutics; 1995:54-1–54-19.
7.
American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 1994;93:137-150.
8.
Hellinger WC, Brewer NS. Symposium on antimicrobial agents. Part VII: Carbapenems and monobactams: Imipenem, meropenem, and aztreonam. Mayo Clin Proc. 1999;74:420-434.
Fish DN, Singletary TJ. Meropenem, a new carbapenem antibiotic. Pharmacotherapy. 1997;17:644-669.
11.
Wilhelm MP, Estes L. Vancomycin. Mayo Clin Proc. 1999;74:928-935.
12.
Han VK, Sayed H, Chance GW, Brabyn DG, Shaheed WA. An outbreak of clostridium difficile necrotizing enterocolitis: A case for oral vancomycin therapy?Pediatrics. 1983;71:935-941.
13.
Cantu TG, Yamanaka-Yuen NA, Lietman PS. Serum vancomycin concentrations: Reappraisal of their clinical value. CID. 1994;18:533-543.
14.
Lamb H, Figgitt D, Faulds D. Quinupristin/dalfopristin: A review of its use in the management of serious gram-positive infections. Drugs. 1999;58:1061-1097.
15.
Clemett D, Markham A. Linezolid. Drugs. 2000;59:815-827.
16.
Stalker DJ, Kearns GL, James L, et al. Pharmakokinetics of linezolid in paediatric patients [abstract]. Clin Infect Dis. 1998;27:1061-1061.
17.
Greene HJ, Burkhart B, Hobby GL. Excretion of penicillin in human milk following parturition. Am J Obstet Gynecol. 1946;51:732-733.
18.
Matheson I, Samseth M, Loberg R, Faegri A, Prentice A. Milk transfer of phenoxymethylpenicillin during puerperal mastitis. Br J Clin Pharmacol. 1988;25:33-40.
19.
Kafetzis DA, Siafas CA, Georgakopoulos PA, Papadatos CJ. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand. 1981;70:285-288.
20.
Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993;168:1393-1399.
21.
CampbellAC, McElnay JC, Passmore CM. The excretion of ampicillin in breast milk and its effect on the suckling infant. Br J Clin Pharmacol. 1991;31:230-230.
22.
Hale T. Medications and Mothers' Milk. 8th ed.Amarillo, Tex: Pharmasoft Medical Publishing; 1999.
23.
Von Kobyletzki D, Dalhoff A, Lindemeyer H, Primavesi CA. Ticarcillin serum and tissue concentrations in gynecology and obstetrics. Infection. 1983;11:144-149.
24.
Yoshioka H, Cho K, Takimato M, Maruyama S, Shimizu T. Transfer of cefazolin into human milk. J Pediatr. 1979;94:151-152.
25.
MischlerTW, Corson SL, Bolognese RJ, Letocha MJ, Neiss ES. Presence of cephradine in body fluids of lactating and pregnant women. Clin Pharmacol Ther. 1974;15:214-214.
26.
Mischler TW, Corson SL, Larranaga A, Bolognese RJ, Neiss ES, Vokovich RA. Cephradine and epicillin in body fluids of lactating and pregnant women. J Reprod Med. 1978;21:130-136.
27.
Briggs GG, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 5th ed.Baltimore, Md: Williams & Wilkins; 1998.
28.
Lou MA Sr, Wu YH, Jacob LS, Pitkin DH. Penetration of cefonicid into human breastmilk and various body fluids and tissues. Rev Infect Dis. 1984;6(suppl 4):S816-S820.
29.
Shyu WC, Shah VR, Campbell DA, et al. Excretion of cefprozil into human breastmilk. Antimic Agents & Chemo. 1992;36:938-941.
30.
Blanco JD, Jorgensen JH, Casteneda YS, Crawford SA. Ceftazidime levels in human breastmilk. Antimicr Agents & Chemo. 1983;23:479-480.
31.
Kafetzis DA, Lazarides CV, Siafas CA, Georgakopoulos PA, Papadatos CJ. Transfer of cefotaxime in human milk and from mother to ftus. J Antimicrob Chemotherapy. 1980;6(suppl):135-141.
32.
Miller RD, Keegan KA, Thrupp LD, Brann J. Human breast milk concentration of moxalactam. Am J Obstet Gynecol. 1984;148:348-349.
33.
Reyes MP, Ostrea EM Jr, Cabinian AE, Schmitt C, Rintelmann W. Vancomycin during pregnancy: Does it cause hearing loss or nephrotoxicity in the infant?Am J Obstet Gynecol. 1989;161:977-981.
34.
Fleiss PM, Richwald GA, Gordon J, Stern M, Frantz M, Devlin RG. Aztreonam in human serum and breast milk. Br J Clin Pharmacol. 1985;19:509-511.
35.
Foulds G, Miller D, Knirch AK, Thrupp LD. Sulbactam kinetics and excretion into breast milk in postpartum women. Clin Pharmacol Ther. 1985;38:692-696.
