Pefloxacin
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
- Ciprofloxacin (Very Low Risk)
- Norfloxacin (Very Low Risk)
- Ofloxacin (Very Low Risk)
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.
Drug trade names
References
- 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
- Harmon T, Burkhart G, Applebaum H. Perforated pseudomembranous colitis in the breast-fed infant. J Pediatr Surg. 1992Abstract
- 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