Cefadroxil and Breastfeeding

Summary of use during lactation

Cefadroxil is no longer marketed in in the US. Limited information indicates that cefadroxil 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 cephalosporins, but these effects have not been adequately evaluated. Cefadroxil is acceptable in nursing mothers.

Drug levels in milk and infant serum

Maternal Levels. After a single 500 mg oral dose of cefadroxil in 5 women, peak milk levels ranged from 0.6 to 0.9 mg/L. Peak levels occurred from 5 to 6 hours after the dose with an average of 0.65 mg/L at 5 hours and 0.68 mg/L at 6 hours after the dose.[1] After a single 1 gram oral dose of cefadroxil in 6 women who were 2 days postpartum, peak levels occurred 6 to 7 hours after the dose and averaged 1.83 mg/L (range 1.2 to 2.4 mg/L).[2] After a single 500 mg oral dose of cefadroxil in 2 or 3 women, peak milk levels of 0.4 mg/L occurred 4 hours after the dose.[3] In all of the above studies, cefadroxil was undetectable in most women's milk for the first hour after the dose. Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

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

Effects on lactation and breastmilk

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

Alternative drugs to consider

(Methicillin-sensitive Staph. aureus) Cefazolin, Cephalexin, Dicloxacillin, Floxacillin, Oxacillin, Methicillin, Nafcillin; (Methicillin-resistant Staph. aureus) Doxycycline, Linezolid, Minocycline, Trimethoprim-Sulfamethoxazole, Vancomycin

References

1. Takase Z, Shirafuji H, Uchida M. Experimental and clinical studies of cefadroxil in the treatment of infections in the field of obstetrics and gynecology. Chemotherapy (Tokyo) 1980;28 (Suppl 2):424-31.
2. Kafetzis DA, Siafas CA, Georgakopoulos PA, et al. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand 1981;70:285-8.7246123 PubMed
3. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol 1984;5:57-60.6743732 PubMed