Is Cefalexin compatible with breastfeeding? Do we have alternatives for Cefalexin?

Cefalexin

October 15, 2016 (Very Low Risk)

First-generation cephalosporin. Oral administration.

Like most cephalosporins for which data are available, excretion occurs in breast milk in very small amount and it is clinically insignificant (Kafetzis 1981, Matsuda 1984, Ilett 2006).

Cephalosporins are widely used in the Pediatric practice with a good tolerance, even in the neonatal period, so it is very unlikely that in small amounts through milk would be a cause of problems in the infant.

Be aware of the possibility of false negative results of cultures in febrile infants whose mothers are taking antibiotics as well as the possibility of gastroenteritis (Ito 1993) by altering the intestinal flora.

Cephalexin is not excreted in significant amount into breast milk (Kafetzis 1981, Matsuda 1984, Ilett 2006).

Be aware of false negative bacterial cultures in the infant when the mother is on antibiotics. Also, diarrheal disease due to imbalance of intestinal flora is possible (Ito 1993, Benyamini 2005). A case of a mother reportedly treated with Cephalexine and Probenecid occurred (Ilett 2006).

Alternatives

We do not have alternatives for Cefalexin 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

  • Cefalexin Hydrochloride
  • Cephalexin

Writings

  • Κεφαλεξίνη (Greek)
  • سيفاليكسين (Arabic)
  • Цефалексин (Cyrillic)
  • 头孢氨苄 (Chinese)
  • セファレキシン (Japanese)
  • C16H17N3O4S,H2O (Molecular formula)

References

  1. Amir LH. ABM Clinical Protocol #4: Mastitis, Revised March 2014. Breastfeed Med. 2014Abstract Full text (link to original source) Full text (in our servers)
  2. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014Abstract
  3. Kong YL, Tey HL. Treatment of acne vulgaris during pregnancy and lactation. Drugs. 2013Abstract
  4. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
  5. 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)
  6. Cabou A, Babineau S, St Anna L. Clinical inquiry: what's the best way to relieve mastitis in breastfeeding mothers? J Fam Pract. 2011Abstract Full text (in our servers)
  7. Jahanfar S, Ng CJ, Teng CL. Antibiotics for mastitis in breastfeeding women. Cochrane Database Syst Rev. 2009Abstract
  8. Spencer JP. Management of mastitis in breastfeeding women. Am Fam Physician. 2008Abstract Full text (link to original source) Full text (in our servers)
  9. Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol #4: mastitis. Revision, May 2008. Breastfeed Med. 2008Abstract
  10. Ilett KF, Hackett LP, Ingle B, Bretz PJ. Transfer of probenecid and cephalexin into breast milk. Ann Pharmacother. 2006Abstract
  11. 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
  12. 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
  13. 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
  14. Fulton B, Moore LL. Antiinfectives in breastmilk. Part I: Penicillins and cephalosporins. J Hum Lact. 1992Abstract
  15. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol. 1984Abstract
  16. Kafetzis DA, Siafas CA, Georgakopoulos PA, Papadatos CJ. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand. 1981Abstract