Ceftriaxone and Breastfeeding

Summary of use during lactation

Limited information indicates that ceftriaxone produce low levels in milk, which 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. Ceftriaxone is acceptable in nursing mothers.

Drug levels in milk and infant serum

Maternal Levels. Following administration of a 1 gram dose of ceftriaxone intramuscularly or intravenously on day 3 postpartum to 20 women, peak milk levels averaged about 0.7 and 0.5 mg/L, respectively. Peaks occurred about 4 hours after the dose and fell very slowly over 24 hours with half-lives of 13 to 17 hours. The amounts in milk represent an infant dosage of about 0.5% of the maternal weight-adjusted dosage.[1] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

A mother who was exclusively nursing her 52-day-old infant developed a soft-tissue infection. She was treated with intravenous teicoplanin 400 mg every 12 hours for 3 doses, then 400 mg daily for 5 days total, intravenous ceftriaxone 1 gram daily, topical mupirocin cream twice daily. A careful follow-up indicated that her infant had no adverse effects.[2]

Effects on lactation and breastmilk

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

References

1. Kafetzis DA, Brater DC, Fanourgakis JE, et al. Ceftriaxone distribution between maternal blood and fetal blood and tissues at parturition and between blood and milk postpartum. Antimicrob Agents Chemother 1983;23:870-3.6311089 PubMed
2. Kaplan YC, Keskin-Arslan E, Acar S, et al. Teicoplanin use during breastfeeding. Breastfeed Med 2017;12:124.28051878 PubMed