Penicillin V and Breastfeeding

Summary of use during lactation

Limited information indicates that penicillin V 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. Penicillin V is acceptable in nursing mothers.

Drug levels in milk and infant serum

Maternal Levels. Milk penicillin V levels were measured in 16 women after an oral dose of 1320 mg. In 7 women with mastitis, peak milk levels averaged 0.72 mg/L in the breast with mastitis and 0.58 mg/L without mastitis. In 4 women without mastitis (control), peak milk levels averaged 0.3 mg/L. Differences in the levels in mastitic milk and control milk were statistically significantly from nonmastitic milk in the women with mastitis in the opposite breast. In the women with mastitis, the peak level occurred 2.6 to 2.7 hours after the dose; in the women without mastitis, the peak occurred 5.4 hours after the dose. The average milk concentration and areas under the curve were greater in the women with mastitis, but the differences were not statistically significant. The authors estimated that an exclusively breastfed infant would receive an average daily dosage of about 50 mcg/kg (range 20 to 90 mcg/kg).[1] Infant Levels. Nursing mothers were given a single oral dose of 1320 mg of penicillin V. In two of the infants who were breastfed, urine penicillin V was measured 2 hours after nursing. In one it was undetectable and in the other, the urine concentration was 520 mcg/L.[1]

Effects in breastfed infants

In one study, 12 infants were breastfed during maternal penicillin V therapy. Seven appeared normal, 3 had looser stools than normal, and 1 had a rash on the buttocks on the last day of therapy. These effects were possibly related to penicillin V in milk, but no control group was present. One infant had stains of blood in the stool, but it had happened once prior to maternal penicillin V treatment.[1]

Effects on lactation and breastmilk

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

References

1. MathesonI SamsethM LobergR Milk transfer of phenoxymethylpenicillin during puerperal mastitis. Br J Clin Pharmacol 1988 25 33 40 3130891 PubMed