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

Clindamycin

March 22, 2018 (Low Risk)

Lincosamide antibacterial.

Excreted in non-significant level into breast milk. Except for few cases of enterocolitis due to disturbance of intestinal flora no other harm effects have been shown in breastfed infants. All cases spontaneously cured after discontinuation of medication.

One reported case (1980) of pseudomembrane colitis in an infant whose mother was on clindamicin and gentamicin.

Be aware of the possibility of false negative results of febrile infant bacterial cultures when the mother is on antibiotics and diarrheal disease due to intestinal flora imbalance.

The American Academy of Pediatrics rates it as compatible with breastfeeding.

Alternatives

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

  • Clindamycin Hydrochloride
  • Clindamycin Palmitate Hydrochloride
  • Clindamycin Phosphate

Writings

  • Κλινδαμυκίνη (Greek)
  • كلينداميسين (Arabic)
  • Клиндамицин (Cyrillic)
  • 克林霉素 (Chinese)
  • クリンダマイシン (Japanese)
  • C18 H33 ClN2 O5 S (Molecular formula)
  • Methyl 6-amino-7-chloro-6,7,8-trideoxy-N-[(2S,4R)-1-methyl-4-propylprolyl]-1-thio-l-threo-d-galacto-octopyranoside (Chemical name)
  • D10AF01; G01AA10; J01FF01 (ATC Code/s)

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. 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)
  5. Mitrano JA, Spooner LM, Belliveau P. Excretion of antimicrobials used to treat methicillin-resistant Staphylococcus aureus infections during lactation: safety in breastfeeding infants. Pharmacotherapy. 2009Abstract
  6. Spencer JP. Management of mastitis in breastfeeding women. Am Fam Physician. 2008Abstract Full text (link to original source) Full text (in our servers)
  7. 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
  8. Worret WI, Fluhr JW. [Acne therapy with topical benzoyl peroxide, antibiotics and azelaic acid]. J Dtsch Dermatol Ges. 2006Abstract
  9. 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)
  10. Chin KG, McPherson CE 3rd, Hoffman M, Kuchta A, Mactal-Haaf C. Use of anti-infective agents during lactation: Part 2--Aminoglycosides, macrolides, quinolones, sulfonamides, trimethoprim, tetracyclines, chloramphenicol, clindamycin, and metronidazole. J Hum Lact. 2001Abstract
  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. Zhang Y, Zhang Q, Xu Z. [Tissue and body fluid distribution of antibacterial agents in pregnant and lactating women]. Zhonghua Fu Chan Ke Za Zhi. 1997Abstract
  13. Fulton B, Moore LL. Antiinfectives in breastmilk. Part II: Sulfonamides, tetracyclines, macrolides, aminoglycosides and antimalarials. J Hum Lact. 1992Abstract
  14. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol. 1984Abstract
  15. Stéen B, Rane A. Clindamycin passage into human milk. Br J Clin Pharmacol. 1982Abstract Full text (link to original source) Full text (in our servers)
  16. Mann CF. Clindamycin and breast-feeding. Pediatrics. 1980Abstract
  17. Smith JA, Morgan JR, Rachlis AR, Papsin FR. Clindamycin in human breast milk. Can Med Assoc J. 1975Abstract Full text (in our servers)