Floxacillin and Breastfeeding

Summary of use during lactation

Floxacillin (flucloxacillin) is not approved for marketing in the United States by the U.S. Food and Drug Administration. It is acceptable to use during breastfeeding and is frequently used abroad to treat mastitis in nursing mothers.[1-3] Limited information indicates that floxacillin levels in milk are low and 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. Floxacillin is acceptable in nursing mothers.

Drug levels in milk and infant serum

Maternal Levels. One report states that the manufacturer supplied information on floxacillin excretion into breastmilk. After a 250 mg oral dose, a milk level of 0.1 mg/L was measured. Further details are lacking.[4] This value is consistent with that of other penicillins. 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, Oxacillin, Methicillin, Nafcillin; (Methicillin-resistant Staph. aureus) Doxycycline, Linezolid, Minocycline, Trimethoprim-Sulfamethoxazole, Vancomycin

References

1. Scott JA, Robertson M, Fitzpatrick J, et al. Occurrence of lactational mastitis and medical management: a prospective cohort study in Glasgow. Int Breastfeed J 2008;3:21.18721487 PubMed
2. Dixon JM, Khan LR. Treatment of breast infection. BMJ 2011;342:d396.21317199 PubMed
3. Amir LH. ABM clinical protocol #4: Mastitis, revised March 2014. Breastfeed Med 2014;9:239-43.24911394 PubMed
4. Griffiths AD, Bull FE. Sweat testing for cystic fibrosis. Arch Dis Child 1978;53:918.727820