Some published studies indicate that Norfloxacin is not excreted into breast milk. A short half life and low oral bioavailability are characteristics that suggest it is the safest quinolone-type antimicrobial to be used while breastfeeding.
Quinolone antibiotics are being used to treat infection in newborn infants without side effect reported. A small amount pass into breast milk but absorption by the child's gut is thought would be interfered by the calcium present in the milk.
Should Fluor-quinolone medication be used in breastfeeding mothers, Nofloxacin, Ofloxacin and Ciprofloxacin are considered to be of choice because a lower concentration in mother's serum.
Follow-up of the child for the appearance of diarrhea is recommended since one case of Colitis pseudomembranosa occurred in a breastfed child who was born premature and complicated with Necrotizing Enterocolitis.
Consider the possibility of false negative results of urine cultures among breastfed infants from treated mothers who are febrile.
We do not have alternatives for Norfloxacin since it is relatively safe.
Very Low Risk
Compatible. Not risky for breastfeeding or infant.
Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.
Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.
Very High Risk
Not recommended. Cessation of breastfeeding or alternative.
- نورفلوكساسين (Arabic)
- Норфлоксацин (Cyrillic)
- 诺氟沙星 (Chinese)
- ノルフロキサシン (Japanese)
Drug trade names
- Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014Abstract
- AEMPS Norfloxacino Ficha técnica 2011 Full text (in our servers)
- Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011Abstract Full text (link to original source) Full text (in our servers)
- Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006Abstract Full text (link to original source) Full text (in our servers)
- 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
- 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
- Gürpinar AN, Balkan E, Kiliç N, Kiriştioğlu I, Doğruyol H. The effects of a fluoroquinolone on the growth and development of infants. J Int Med Res. 1997Abstract
- Fleiss PM. The effect of maternal medications on breastfeeding infants. J Hum Lact. 1992Abstract
- Harmon T, Burkhart G, Applebaum H. Perforated pseudomembranous colitis in the breast-fed infant. J Pediatr Surg. 1992Abstract
- Wise R. Norfloxacin--a review of pharmacology and tissue penetration. J Antimicrob Chemother. 1984Abstract