Cefotaxime and Breastfeeding

Summary of use during lactation

Cefotaxime is no longer marketed in the United States. Limited information indicates that cefotaxime 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. Cefotaxime is acceptable in nursing mothers.

Drug levels in milk and infant serum

Maternal Levels. Five postpartum women were given 2 grams of cefotaxime twice daily for 4 days. The average peak milk level on day 4 was 0.68 mg/L (range 0.29 to1.57 mg/L). By 12 hours after the dose the drug was undetectable in milk of all 5 women.[1] After a single 1 gram dose of cefotaxime to 12 women, average peak levels of 0.32 mg/L occurred 2 hours after the dose. The highest milk level recorded was 0.52 mg/L in one woman at 3 hours after the dose.[2,3] After a single 1 gram dose of cefotaxime to 5 women, the drug was not measurable (<0.1 mg/L) in the mothers' milk at any time up to 6 hours after the dose.[4] After a single 1 gram intravenous dose in 2 women, cefotaxime milk levels were not measurable at any time up to 6 hours after the dose.[5] 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.

References

1. Harms K, Gerke G, Zaloudek D. Konzentrationsbestimmungen von cefotaxim aus der muttermilch. Infection 1980;8 (Suppl 4):S451-3.
2. Kafetzis DA, Lazarides CV, Siafas CA, et al. Transfer of cefotaxime in human milk and from mother to foetus. J Antimicrob Chemother 1980;6 (Suppl A):135-41.6252147 PubMed
3. Kafetzis DA, Siafas CA, Georgakopoulos PA, Papadatos CJ. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand 1981;70:285-8.7246123 PubMed
4. Takase Z, Fujiwara M, Kohmoto Y, et al. Study of cefotaxime in the perinatal period. Jpn J Antibiot 1982;35:1893-7.6294369 PubMed
5. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol 1984;5:57-60.6743732 PubMed