Spiramycin

It is assumed that excretion into breast milk achieves bacteriostatic concentrations.
A latest update no published data were found on excretion into breast milk.

Because a high molecular weight it seems unlikely an excretion into breast milk in significant amount.
A low oral bioavailability further reduced with simultaneous food intake impairs the appearance in the infant plasma from ingested milk except in preterm babies and those in the immediate neonatal period, which may have increased intestinal permeability.

Macrolide-based medication that is used in infants.
Until more published data on this drug regarding breastfeeding is available, safer alternatives with better known drugs should be preferable especially during the neonatal period and in case of prematurity..

Take into account the possible negative cultures in febrile infants whose mothers take antibiotics

Alternatives

• Azithromycin (Very Low Risk)
• Clarithromycin (Very Low Risk)
• Pyrimethamine (Very Low Risk)