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

Vancomycin

May 1, 2016 (Very Low Risk)

Antibacterial glycopeptide drug.

A high molecular weight its a reason to be excreted in clinically non-significant amount into breast milk, much lower than the dose commonly used for infection in newborns and infants.
Its low oral bioavailability hinders the passage toward infant’s plasma from ingested mother’s milk, except in preterm infants and immediate neonatal period, in which the infant may have an increased intestinal permeability.

Take into account the possibility of negative results of bacterial cultures from febrile infants when their mothers are receiving antibiotics.

Alternatives

We do not have alternatives for Vancomycin 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.

Writings

  • βανκομυκίνη (Greek)
  • فانكوميسين (Arabic)
  • Ванкомицин (Cyrillic)
  • 万古霉素 (Chinese)
  • バンコマイシン (Japanese)
  • C66H75Cl2N9O24 (Molecular formula)

Drug trade names

References

  1. Amir LH. ABM Clinical Protocol #4: Mastitis, Revised March 2014. Breastfeed Med. 2014Abstract Full text (link to original source) Full text (in our servers)
  2. Rao S, Kupfer Y, Pagala M, Chapnick E, Tessler S. Systemic absorption of oral vancomycin in patients with Clostridium difficile infection. Scand J Infect Dis. 2011Abstract
  3. 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)
  4. Mitrano JA, Spooner LM, Belliveau P. Excretion of antimicrobials used to treat methicillin-resistant Staphylococcus aureus infections during lactation: safety in breastfeeding infants. Pharmacotherapy. 2009Abstract
  5. Nahum GG, Uhl K, Kennedy DL. Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks. Obstet Gynecol. 2006Abstract
  6. 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)
  7. Chin KG, Mactal-Haaf C, McPherson CE. Use of anti-infective agents during lactation: Part 1--Beta-lactam antibiotics, vancomycin, quinupristin-dalfopristin, and linezolid. J Hum Lact. 2000Abstract
  8. Reyes MP, Ostrea EM Jr, Cabinian AE, Schmitt C, Rintelmann W. Vancomycin during pregnancy: does it cause hearing loss or nephrotoxicity in the infant? Am J Obstet Gynecol. 1989Abstract