Is Amoxicillin-Clavulanate compatible with breastfeeding? Do we have alternatives for Amoxicillin-Clavulanate?

Amoxicillin-Clavulanate

March 3, 2018 (Very Low Risk)

Excretion into breast milk is insignificant (Kafetzis 1981).

No adverse effects requiring medical attention have been observed in the majority of nursing infants whose mothers took this medication (Benyamini 2005).

It is commonly prescribed for infants by Pediatricians.

It is considered medication compatible with breastfeeding by relevant authors and scientific societies (Rowe 2013, Amir 2011, Spencer 2008, Nahum 2006, Mahadevan 2006, Drobac 2005, Bar-Oz 2003, Chin 2000).

The possible negativity of cultures in febrile infants whose mothers take antibiotics should be taken into account, as well as the possibility of gastroenteritis due to altered intestinal flora (Benyamini 2005.

Eleventh WHO Model List of Essential Drugs: Compatible with breastfeeding (WHO / UNICEF 2002).

Alternatives

We do not have alternatives for Amoxicillin-Clavulanate since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Writings

  • Αμοξυκιλλίνη + Κλαβουλανικό οξύ (Greek)
  • أموكسيسيلين Clavulanate (Arabic)
  • Амоксициллин Калия Клавуланат (Cyrillic)
  • 阿莫西林 Clavulanate (Chinese)
  • アモキシシリン クラブラン酸カリウム (Japanese)
  • J01CR02 (ATC Code/s)

References

  1. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
  2. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011Abstract Full text (link to original source) Full text (in our servers)
  3. Spencer JP. Management of mastitis in breastfeeding women. Am Fam Physician. 2008Abstract Full text (link to original source) Full text (in our servers)
  4. Nahum GG, Uhl K, Kennedy DL. Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks. Obstet Gynecol. 2006Abstract
  5. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006Abstract Full text (link to original source) Full text (in our servers)
  6. Drobac PC, del Castillo H, Sweetland A, Anca G, Joseph JK, Furin J, Shin S. Treatment of multidrug-resistant tuberculosis during pregnancy: long-term follow-up of 6 children with intrauterine exposure to second-line agents. Clin Infect Dis. 2005Abstract Full text (link to original source) Full text (in our servers)
  7. Benyamini L, Merlob P, Stahl B, Braunstein R, Bortnik O, Bulkowstein M, Zimmerman D, Berkovitch M. The safety of amoxicillin/clavulanic acid and cefuroxime during lactation. Ther Drug Monit. 2005Abstract
  8. Amoxicilina-Clavulánico Ficha técnica 2004 Full text (in our servers)
  9. Bar-Oz B, Bulkowstein M, Benyamini L, Greenberg R, Soriano I, Zimmerman D, Bortnik O, Berkovitch M. Use of antibiotic and analgesic drugs during lactation. Drug Saf. 2003Abstract
  10. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  11. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  12. Chin KG, Mactal-Haaf C, McPherson CE. Use of anti-infective agents during lactation: Part 1--Beta-lactam antibiotics, vancomycin, quinupristin-dalfopristin, and linezolid. J Hum Lact. 2000Abstract
  13. Kafetzis DA, Siafas CA, Georgakopoulos PA, Papadatos CJ. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand. 1981Abstract