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

Gentamicin

July 1, 2015 (Very Low Risk)

Excreted into breast milk in non-significant amount. Harmful effect has not been shown in breastfed infants whose mothers were treated with Gentamicin, except on case of a child who presented with bloody stools while the mother was receiving Gentamicin and Clindamycin.

Low intestinal absorption leads to low or nil concentration in blood serum, with exception of premature infants or early neonatal period in which higher absorption may occur.

Consider the possibility of false negative results of bacterial cultures among febrile breastfed infants whose mothers are treated with Gentamicin. Gastroenteritis due to intestinal flora imbalance is also likely.

When eye drops are used like many other topical ophtalmologic preparations that use low doses with scanty excretion into serum are considered to be compatible with breastfeeding.

The American Academy of Pediatrics rates it compatible with breastfeeding.

The WHO Model List of Essential Medicines 2002 rates it as compatible with breastfeeding.

Alternatives

We do not have alternatives for Gentamicin 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.

Writings

  • Гентамицина (Cyrillic)
  • ゲンタマイシン (Japanese)

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. 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
  3. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006Abstract Full text (link to original source) Full text (in our servers)
  4. 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)
  5. 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
  6. 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)
  7. 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
  8. Celiloglu M, Celiker S, Guven H, Tuncok Y, Demir N, Erten O. Gentamicin excretion and uptake from breast milk by nursing infants. Obstet Gynecol. 1994Abstract
  9. Fulton B, Moore LL. Antiinfectives in breastmilk. Part II: Sulfonamides, tetracyclines, macrolides, aminoglycosides and antimalarials. J Hum Lact. 1992Abstract
  10. Boda A. [Gentamycin concentration in the milk of a mother after treatment by implantation of a Septopal chain]. Orv Hetil. 1990Abstract
  11. Mann CF. Clindamycin and breast-feeding. Pediatrics. 1980Abstract