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

Levofloxacin

June 30, 2015 (Low Risk)

Is the S-isomer of ofloxacin.

Recently, quinolone-related medication has been used in neonates and infants without apparent side effects. It trespasses in tiny amounts into breast milk. Absorption through the child’s gut may be interfered by the calcium contained in the milk.

Should it be necessary to prescribe it to a nursing mother, Norfloxacine, Ofloxacine and Ciprofloxacine have shown a lower level in the milk and thus must be the preferred drugs.

Because a case of pseudomembranose colitis has been described possibly related to mother ingestion of Ciporfloxacine in a premature infant previously affected of NEC, a close follow-up for diarrhea is warranted.

Be aware of the possibility of false negative results of bacterial cultures when the mother is on antibiotics.

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

  • ليفوفلوكساسين (Arabic)
  • Левофлоксацин (Cyrillic)
  • 左氧氟沙星 (Chinese)
  • レボフロキサシン (Japanese)

Drug trade names

References

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  3. 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
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  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. van den Oever HL, Versteegh FG, Thewessen EA, van den Anker JN, Mouton JW, Neijens HJ. Ciprofloxacin in preterm neonates: case report and review of the literature. Eur J Pediatr. 1998Abstract
  7. Fleiss PM. The effect of maternal medications on breastfeeding infants. J Hum Lact. 1992Abstract
  8. Harmon T, Burkhart G, Applebaum H. Perforated pseudomembranous colitis in the breast-fed infant. J Pediatr Surg. 1992Abstract
  9. Giamarellou H, Kolokythas E, Petrikkos G, Gazis J, Aravantinos D, Sfikakis P. Pharmacokinetics of three newer quinolones in pregnant and lactating women. Am J Med. 1989Abstract