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

Erythromycin

August 2, 2016 (Low Risk)

Excreted in very low levels into breast milk.

Commonly used for pediatric treatment of small babies; it is very well tolerated by infants.

Erythromycin is a macrolide that has been related to hypertrophic pyloric stenosis after early exposition through the breast milk. Avoiding its use in the first post-partum month would be a cautious measure.

Be aware of the possibility of false negative results of bacterial cultures when the mother is on antibiotics. Also, diarrheal disease due to imbalance of intestinal flora is possible

Small doses used for treatment of dermatologic and ophthalmologic conditions, together with a very low level in the mother’s plasma make very unlikely a significant excretion into breast milk.

Topically used Erythromycin is safe while breastfeeding. Systemic treatments would be safer after the first month of life.

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

List of Essential Medicines WHO 2002: 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.

Writings

  • Ερυθρομυκίνη (Greek)
  • Эритромицин (Cyrillic)
  • 红霉素 (Chinese)
  • エリスロマイシン (Japanese)

Drug trade names

References

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  3. ASGE Standard of Practice Committee, Shergill AK, Ben-Menachem T, Chandrasekhara V, Chathadi K, Decker GA, Evans JA, Early DS, Fanelli RD, Fisher DA, Foley KQ, Fukami N, Hwang JH, Jain R, Jue TL, Khan KM, Lightdale J, Pasha SF, Sharaf RN, Dominitz JA, Cash BD. Guidelines for endoscopy in pregnant and lactating women. Gastrointest Endosc. 2012Abstract Full text (link to original source) Full text (in our servers)
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  6. Maheshwai N. Are young infants treated with erythromycin at risk for developing hypertrophic pyloric stenosis? Arch Dis Child. 2007Abstract Full text (link to original source) Full text (in our servers)
  7. Sørensen HT, Skriver MV, Pedersen L, Larsen H, Ebbesen F, Schønheyder HC. Risk of infantile hypertrophic pyloric stenosis after maternal postnatal use of macrolides. Scand J Infect Dis. 2003Abstract
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  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. [No authors listed] Erythromycin-induced pyloric stenosis in infants. Prescrire Int. 2001Abstract
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