Is Imipenem + Cilastatin compatible with breastfeeding? Do we have alternatives for Imipenem + Cilastatin?

Imipenem + Cilastatin

December 8, 2017 (Very Low Risk)

Intravenous administration, every 6 to 8 hours.

Like other beta-lactams, it is excreted in breast milk in a clinically insignificant amount (Matsuda 1988, Ito 1988).

Its practically no oral bioavailability would make it difficult for the infant to pass through the breast milk ingested, except in preterm infants and an immediate neonatal period in which there may be increased intestinal permeability.

Mediation of authorized use in infants and neonates (Merck 2016).

The possible negativity of cultures in febrile infants whose mothers take antibiotics should be taken into account, as well as the possibility of gastroenteritis due to altered intestinal flora (Benyamini 2005, Ito 1993, Kafetzis 1981).

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

  • N-formimidoyl thienamycin

Writings

  • Ιμιπενέμη (Greek)
  • إيميبينام (Arabic)
  • Имипенем (Cyrillic)
  • 亚胺培南 (Chinese)
  • 無水イミペネム; イミペネム (Japanese)
  • Imipénem (French)
  • C12H17N3O4S,H2O (Molecular formula)
  • J01DH01 (ATC Code/s)

Drug trade names

References

  1. 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
  2. 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
  3. Ito K, Izumi K, Takagi H, Tamaya T, Hayasaki M. [Fundamental and clinical evaluation of imipenem/cilastatin sodium in the perinatal period]. Jpn J Antibiot. 1988Abstract
  4. Matsuda S, Suzuki M, Oh K, Ishikawa M, Soma A, Takada H, Shimizu T, Makinoda S, Fujimoto S, Chimura T, et al. [Pharmacokinetic and clinical studies on imipenem/cilastatin sodium in the perinatal period. A study of imipenem/cilastatin sodium in the perinatal co-research group]. Jpn J Antibiot. 1988Abstract
  5. Kafetzis DA, Siafas CA, Georgakopoulos PA, Papadatos CJ. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand. 1981Abstract