Josamycin

A macrolide antibiotic that is approved for pediatric use. Frequently used in young infants

At latest update no published data on excretion into breast milk were found.

It has higher molecular weight and shorter half-life elimination span than other macrolide antibiotics like azithromycin and claritormycin that are excreted into breast milk in negligible amount.
Until more published information about this drug regarding breastfeeding appears, it may be preferable a known and safer alternative, especially during the neonatal period and in cases of prematurity.

Early exposure to macrolide antibiotics (especially erythromycin) has been linked to hypertrophic pyloric stenosis, even through breast milk, being it a reason to avoid them during the first month of breastfeeding.

Take into account the possible negative results of bacterial cultures among febrile infants when their mothers are on antibiotics, as well as the possibility of gastroenteritis by altering the intestinal flora.

Alternatives

• Clarithromycin (Very Low Risk)
• Erythromycin (Low Risk probable)