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

Ofloxacin

January 17, 2016 (Very Low Risk)

It is excreted in breast milk in small quantities.

Quinolone-derived drugs are being used in neonates and young infants, without the appearance of side effects. They are barely excreted into the milk and the absorption in the child’s intestine is hampered by the presence of calcium in the milk.

As long as it is necessary the use of fluoroquinolones in a lactating mother, norfloxacin, ofloxacin and ciprofloxacin should be chosen since they reach lower levels in the milk.

Check-up the baby for occurrence of diarrhea, since a case of pseudomembranous colitis was published possibly related to maternal intake of ciprofloxacin in a premature child who had suffered from necrotizing enterocolitis.

Take into account the possibility of negative-culture results in febrile infants whose mothers are on antibiotics.

American Academy of Pediatrics classifies it as usually compatible with breastfeeding medication.

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

  • οφλοξακίνη (Greek)
  • أوفلوكساسين (Arabic)
  • 氧氟沙星 (Chinese)
  • オフロキサシン (Japanese)
  • C18H20FN3O4 (Molecular formula)

References

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  2. Arbex MA, Varella Mde C, Siqueira HR, Mello FA. Antituberculosis drugs: drug interactions, adverse effects, and use in special situations. Part 2: second line drugs. J Bras Pneumol. 2010Abstract Full text (link to original source) Full text (in our servers)
  3. Cahill JB Jr, Bailey EM, Chien S, Johnson GM. Levofloxacin secretion in breast milk: a case report. Pharmacotherapy. 2005Abstract
  4. Drobac PC, del Castillo H, Sweetland A, Anca G, Joseph JK, Furin J, Shin S. Treatment of multidrug-resistant tuberculosis during pregnancy: long-term follow-up of 6 children with intrauterine exposure to second-line agents. Clin Infect Dis. 2005Abstract Full text (link to original source) Full text (in our servers)
  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. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  7. Zhang Y, Zhang Q, Xu Z. [Tissue and body fluid distribution of antibacterial agents in pregnant and lactating women]. Zhonghua Fu Chan Ke Za Zhi. 1997Abstract
  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