Lora:
A másik gyógyszer antibiotikum ami sajnos átjut a baba szervezetébe és megrongálhatja a bélflóráját, hasmenést okozhat. Az infó szerint az anya dózisának 1-2,5% jut át az anyatejbe.
Ebben a helyzetben én azt tenném, hogy óvatosan megszoptatnám, és közben adnék neki Normaflore-t, hogy a bélflóráját óvjam. Ő már nem újszülött, fejlettebb az emésztőrendszere, ráadásul mást is eszik, nemcsak anyatejet, és az 1-2,5% szerintem nagyon kevés.
Persze ha az orvos gondol rá, vagy ismeri a szakirodalmat, adhatott volna más antibiotikumot, ami még ennyire sem jut át az anyatejbe.
Itt az infó:
Clindamycin
CASRN: 18323-44-9
For other data, click on the Table of Contents
Drug Levels and Effects:
Summary of Use during Lactation:
Clindamycin has the potential to cause adverse effects on the breastfed infant's gastrointestinal flora. If oral or intravenous clindamycin is required by a nursing mother,
it is not a reason to discontinue breastfeeding, but an alternate drug may be preferred. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis.
Infant side effects are unlikely with vaginal or topical application, although about 30% of a vaginal dose is absorbed and topical application to the nipple may increase the risk of diarrhea in the infant.
Drug Levels:
Maternal Levels. Two women were give clindamycin 150 mg orally. Breastmilk levels of clindamycin averaged 1.3 mg/L 4 hours after the dose.[1]
Two women were treated with clindamycin 600 mg intravenously every 6 hours followed by 300 mg orally every 6 hours. Peak milk levels after the intravenous dose were 2.65 mg/L at 3.5 hours after the dose in one and 3.1 mg/L at 30 minutes after the dose in the other. During the oral regimen, peak milk levels were 1.3 mg/L at 3.5 hours after the dose in the first woman and 1.8 mg/L at 2 hours after the dose in the other.[2]
Five women were given oral clindamycin 150 mg three times daily during the first 2 weeks postpartum. Milk levels were measured after at least 1 week of therapy and averaged 1.2 mg/L (range <0.5 mg/L to 3.1 mg/L) 6 hours after the dose.[3]
After a single oral dose of 150 mg of clindamycin in 2 women, milk levels averaged from 0.3 to 1.2 mg/L between 1 and 6 hours after the dose. The peak occurred at 2 hours after the dose in one woman and 4 hours after the dose in the other.[4]
After a single dose of 600 mg of clindamycin intravenously to 15 women who were 1 month postpartum, milk clindamycin levels averaged 1.03 mg/L 2 hours after the dose.[5]
In summary, the amounts in milk represent an infant dosage of about 1 to 2.5% of the maternal weight-adjusted dosage.[2][3][5]
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants:
Bloody stools in a 5-day-old breastfed infant were possibly caused by concurrent maternal clindamycin 600 mg intravenously every 6 hours and gentamicin 80 mg intravenously every 8 hours. The infant's stools were reported to have normal flora and the stools became guaiac negative 24 hours after discontinuation of breastfeeding. On day 6 of age, the infant resumed breastfeeding after discontinuation of maternal antibiotics with no further difficulties.[6]
Possible Effects on Lactation:
Relevant published information was not found as of the revision date.
AAP Category:
Usually compatible with breastfeeding.[7]
Alternate Drugs to Consider:
(Systemic) Amoxicillin and Clavulanic Acid, Doxycycline, Erythromycin, (Topical) Bacitracin, Mupirocin
References:
1. Matsuda S, Mori S, Azuma S. Clinical evaluation of clindamycin in gyneco-obstetrics. Chemotherapy (Tokyo). 1969;17:899-900.
2. Smith JA, Morgan JR, Rachlis AR et al. Clindamycin in human breast milk. Can Med Assoc J. 1975;112:806. Letter.
3. Steen B, Rane A. Clindamycin passage into human milk. Br J Clin Pharmacol. 1982;13:661-4. PMID: 7082533
4. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol. 1984;5:57-60. PMID: 6743732
5. Zhang Y, Zhang Q, Xu Z. [Tissue and body fluid distribution of antibacterial agents in pregnant and lactating women]. Zhonghua Fu Chan Ke Za Zhi. 1997;32:288-92. PMID: 9596854
6. Mann CF. Clindamycin and breast-feeding. Pediatrics. 1980;66:1030-1. Letter. PMID: 7454470
7. American Academy of Pediatrics. Committee on Drugs. The transfer of drugs and other chemicals into human milk. Pediatrics. 2001;108:776-89. PMID: 11533352
Substance Identification:
Substance Name: Clindamycin
CAS Registry Number: 18323-44-9
Drug Class:
Anti-Infective Agents
Administrative Information:
LactMed Record Number:
343
Last Revision Date:
20071227