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

Tobramycin

November 5, 2014 (Very Low Risk)

Excreted into breast milk in non-significant amount without harm effects observed among breastfed infants of mothers treated with Tobramycin.

In addition, a low oral bioavailability renders concentration in the infant's plasma be nil or low.

Be aware of false negative results that may be obtained from infants with bacterial cultures when the mother is on antibiotics and higher risk of acute diarrhea by alteration of normal gut flora.

When used in eye drops, because of a low dose and topical application with minimal absorption in the serum, it is compatible while breastfeeding.

Alternatives

We do not have alternatives for Tobramycin since it is relatively safe.

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.

Synonyms

  • トブラマイシン
  • توبراميسين
  • τοβραμυκίνη
  • Тобрамицин
  • 妥布霉素

References

  1. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
  2. Festini F, Ciuti R, Taccetti G, Repetto T, Campana S, De Martino M. Breast-feeding in a woman with cystic fibrosis undergoing antibiotic intravenous treatment. J Matern Fetal Neonatal Med. 2006Abstract
  3. Festini F. Ciuti R, Repetto T, Taccetti G, Neri A, Campana S, Mergni G, de Martino M. Safety of breast-feeding during an IV tobramycin course for infants of CF women. Pediatr Pulmonol Suppl. 2004;27:288-9. Poster-Abstract 291. 2004
  4. 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
  5. Bourget P, Quinquis-Desmaris V, Fernandez H. Ceftriaxone distribution and protein binding between maternal blood and milk postpartum. Ann Pharmacother. 1993Abstract
  6. Niebyl JR. Use of antibiotics for ear, nose, and throat disorders in pregnancy and lactation. Am J Otolaryngol. 1992Abstract
  7. Fulton B, Moore LL. Antiinfectives in breastmilk. Part II: Sulfonamides, tetracyclines, macrolides, aminoglycosides and antimalarials. J Hum Lact. 1992Abstract
  8. Uwaydah M, Bibi S, Salman S. Therapeutic efficacy of tobramycin--a clinical and laboratory evaluation. J Antimicrob Chemother. 1975Abstract