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

Meropenem

December 8, 2017 (Very Low Risk)

Antibacterial carbapenem beta-lactam with indications similar to imipenem.
Intravenous administration every 8 hours.

It is excreted in breast milk in a clinically insignificant amount (Sauberan 2012) and no problems have been observed in infants whose mothers took it (Festini 2004).

Authorized pediatric use in infants and newborns.

It is considered by experts to be compatible with breastfeeding (Rowe 2013).

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

We do not have alternatives for Meropenem 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

  • μεροπενέμη (Greek)
  • ميروبينام (Arabic)
  • Меропенем (Cyrillic)
  • 美罗培南 (Chinese)
  • メロペネム (Japanese)
  • Méropénem (French)
  • C17H25N3O5S,3H2O (Molecular formula)
  • (4R,5S,6S)-3-[(3S,5S)-5-Dimethylcarbamoylpyrrolidin-3-ylthio]-6-[(R)-1-hydroxyethyl]-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic acid trihydrate (Chemical name)
  • J01DH02 (ATC Code/s)

References

  1. AEMPS. Meropenem. Ficha técnica. 2016 Full text (in our servers)
  2. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
  3. Sauberan JB, Bradley JS, Blumer J, Stellwagen LM. Transmission of meropenem in breast milk. Pediatr Infect Dis J. 2012Abstract
  4. AstraZeneca. Meropenem. Drug Summary. 2006 Full text (in our servers)
  5. 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
  6. Festini F. Ciuti R, Repetto T, Taccetti G, Neri A, Campana S, Mergni G, de Martino M. Safety of breast-feeding during an IV tobramycin course for infants of CF women. Pediatr Pulmonol Suppl. 2004;27:288-9. Poster-Abstract 291. 2004
  7. 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
  8. Kafetzis DA, Siafas CA, Georgakopoulos PA, Papadatos CJ. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand. 1981Abstract