Moxifloxacin

It is a Fluoroquinolone-type antibiotic which is similar to Ciprofloxacin on both characteristics and indications.

At latest update, relevant published data on excretion into breast milk were not found. Until more data on this medication is available, safer alternative drugs are preferred, especially in such critical age periods.

Should a Fluoroquinolone-type antibiotic be necessary, Norfloxacin, Ofloxacin or Ciprofloxacin are preferred since they achieve the lowest levels in the plasma.

When topically applied, as with eye drops, the small dose used and limited absorption to the plasma, which is common for most ophthalmic preparations, it is excreted in a non-significant amount into breast milk.

In addition, quinolone-type medications have been used in neonates and infants without overt side effects (joint, bone or teeth impairment). It is excreted in tiny amounts into breast milk. Absorption through the child’s gut may be interfered by the calcium contained in the milk.

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

Be aware of the risk for false negative results of bacterial cultures in the infant, when the mother is taking antibiotics.

Alternatives

• Ciprofloxacin (Very Low Risk)
• Norfloxacin (Very Low Risk)
• Ofloxacin (Very Low Risk)