Bacampicillin and Breastfeeding

Summary of use during lactation

Limited information indicates that bacampicillin produces low levels in milk that are not expected to cause adverse effects in breastfed infants. Occasionally disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush have been reported with penicillins, but these effects have not been adequately evaluated. Bacampicillin is acceptable in nursing mothers.

Drug levels in milk and infant serum

Maternal Levels. Only traces of drug could be detected in breastmilk after a 500 mg oral dose of bacampicillin in 2 women.[1] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Bacampicillin is rapidly converted to ampicillin. Some adverse reactions from ampicillin have been reported. An uncontrolled observation of the breastfed infants of mothers taking ampicillin noted a seeming increase in cases of diarrhea and candidiasis that was attributed to ampicillin in breastmilk.[2] In a prospective follow-up study, 5 nursing mothers reported taking ampicillin (dosage unspecified). One mother reported diarrhea in her infant. No rashes or candidiasis were reported among the exposed infants.[3] A small, controlled, prospective study had mothers monitor their infants for signs of adverse effects (furring of the tongue, feeding difficulties, changes in stool frequency and consistency, diaper rash, and skin rash). Weight change and the development of jaundice were also recorded. No statistical differences in these parameters were found between the infants of the control mothers and those of mothers taking ampicillin.[4] Naproxen possibly caused prolonged bleeding time, thrombocytopenia and acute anemia in one 7-day-old infant in a mother also taking bacampicillin.[5] The role of bacampicillin in this reaction is unknown.

Effects on lactation and breastmilk

Relevant published information was not found as of the revision date.

References

1. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol 1984;5:57-60.6743732 PubMed
2. Williams M. Excretion of drugs in milk. Pharm J 1976;217:219.
3. Ito S, Blajchman A, Stephenson M, et al. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol 1993;168:1393-9.8498418 PubMed
4. Campbell AC, McElnay JC, Passmore CM. The excretion of ampicillin in breast milk and its effect on the suckling infant. Br J Clin Pharmacol 1991;31:230p. doi:10.1111/j.1365-2125.1991.tb05523.x
5. Fidalgo I, Correa R, Gómez Carrasco, JA, et al. Acute anemia, rectorrhagia and hematuria caused by ingestion of naproxen. An Esp Pediatr 1989;30:317-9.2787136 PubMed