Is Ampicillin-Sulbactan compatible with breastfeeding? Do we have alternatives for Ampicillin-Sulbactan?

Ampicillin-Sulbactan

July 26, 2018 (Very Low Risk)

Both ampicillin and sulbactam are excreted in breast milk in insignificant amounts (Campbell AC 1991, Matheson I 1988, Nau H 1987, Foulds G 1985, Matsuda S 1985) and no side effects have been observed in infants whose mothers were taking it ( AAP 2001).

Follow-up for appearance of diarrhea since alteration of intestinal flora can occur (Chin KG 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, Ito 1993, Kafetzis 1981).

Alternatives

We do not have alternatives for Ampicillin-Sulbactan 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.

Synonyms

  • Sultamicilin
  • Sultamicilline
  • Sultamicillin Tosilate

Writings

  • سولتاميسيلين (Arabic)
  • Сультамициллин (Cyrillic)
  • 舒他西林 (Chinese)
  • スルタミシリン (Japanese)
  • Sultamicilline (French)
  • C25H30N4O9S2 (Molecular formula)
  • Penicillanoyloxymethyl (6R)-6-(d-2-Phenylglycylamino)penicillanate S′,S′-dioxide (Chemical name)

Drug trade names

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. 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
  3. 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)
  4. 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
  5. 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. 1993Abstract
  6. Fulton B, Moore LL. Antiinfectives in breastmilk. Part I: Penicillins and cephalosporins. J Hum Lact. 1992Abstract
  7. [No authors listed] Proceedings of the British Pharmacological Society. 12-14 September 1990, Belfast. Br J Clin Pharmacol. 1991Abstract
  8. Campbell AC, McElnay JC, Passmore CM. The excretion of ampicillin in breast milk and its effect on the suckling infant. Br J Clin Pharmacol;31:230p. Abstract. 1991 Full text (link to original source) Full text (in our servers)
  9. Matheson I, Samseth M, Sande HA. Ampicillin in breast milk during puerperal infections. Eur J Clin Pharmacol. 1988Abstract
  10. Nau H. Clinical pharmacokinetics in pregnancy and perinatology. II. Penicillins. Dev Pharmacol Ther. 1987Abstract
  11. Matsuda S, Kashiwagura T, Hirayama H. [Passage into the human milk and clinical evaluation of sulbactam/cefoperazone]. Jpn J Antibiot. 1985Abstract
  12. Foulds G, Miller RD, Knirsch AK, Thrupp LD. Sulbactam kinetics and excretion into breast milk in postpartum women. Clin Pharmacol Ther. 1985Abstract
  13. Kafetzis DA, Siafas CA, Georgakopoulos PA, Papadatos CJ. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand. 1981Abstract