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


March 21, 2018 (Very Low Risk)

Fluoroquinolone with bactericidal effect by inhibition of bacterial DNA synthesis.
Oral administration twice a daily.

It is excreted in tiny amounts into breast milk. (Gardner 1992, Cover 1990, Giamarellou 1989), much lower than the dose used to treat newborns or infants (van den Oever 1998).
No problems have been observed in infants whose mothers took it (Drobac 2005, Gardner 1992).
The plasma levels of these infants were undetectable or very low (Gardner 1992).

Quinolone-related medication has been used in neonates and infants without known side effects (Dutta 2006, Belet 2004, Drossou 2004, Chin 2001, van den Oever 1998, Gürpinar 1997). It is excreted in tiny amounts into breast milk and absorption through the child’s gut may be interfered by calcium in the milk (Fleiss 1992).

One case of pseudomembranose colitis, possibly related to mother ingestion of Ciporfloxacine, in a premature infant has been described who previously was affected of Necrotizing Enterocolitis (Harmon 1992).
Follow-up for diarrhea in the infant is warranted.

Should it be prescribed to a nursing mother Norfloxacine, Ofloxacine and Ciprofloxacine are to be chosen since they have shown a lowest excretion into the milk (Butler 2014).

The possible negativity of cultures in febrile infants whose mothers take antibiotics should be taken into account,

There are authors and medical associations that discourage their use during breastfeeding (van der Woude 2015, Mottet 2009, WHO 2002) and others that do not (Huang 2016, Butler 2014, Huang 2014, Schulze 2014, Chen 2010, Spencer 2008, Nahum 2006, Mahadevan 2006, Bar-Oz 2003, Chin 2001), recommending avoiding long-term treatments.
In a cross-sectional survey of Canadian physicians, only 50% of physicians stopped treatment with ciprofloxacin during breastfeeding (Huang 2016).

American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).


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.


  • Σιπροφλοξασίνη (Greek)
  • سيبروفلوكساسين (Arabic)
  • Ципрофлоксацин (Cyrillic)
  • 环丙沙星 (Chinese)
  • シプロフロキサシン (Japanese)
  • C17 H18 FN3 O3 (Molecular formula)
  • 1-Cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7-piperazin-1-ylquinoline-3-carboxylic acid (Chemical name)
  • J01MA02 (ATC Code/s)


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