Document Detail

Excretion of antimicrobials used to treat methicillin-resistant Staphylococcus aureus infections during lactation: safety in breastfeeding infants.
MedLine Citation:
PMID:  19698015     Owner:  NLM     Status:  MEDLINE    
Community-acquired strains of methicillin-resistant Staphylococcus aureus (MRSA) have become a common cause of skin and soft tissue infections in the United States. These infections sometimes require treatment with antibiotics, and with the increasing resistance of pathogens to these agents, choosing the appropriate drug can be difficult. In lactating women who develop these infections, selecting an antibiotic is even more challenging, as clinicians need to be aware of risks to the infant from the drug excreted during lactation. To our knowledge, no review has addressed the safety of antibiotics in breastfeeding infants when the drugs are used to treat maternal skin and soft tissue infections from MRSA. Thus, we performed a literature search of the PubMed-MEDLINE and EMBASE databases (1974-March 2009), reviewed reference citations from identified publications, researched antibiotic prescribing information, and corresponded with drug manufacturers. Case reports, case series, and both in vivo and in vitro clinical trials were evaluated for the following antibiotics: clindamycin, daptomycin, linezolid, quinupristin-dalfopristin, rifampin, tetracycline, doxycycline, minocycline, tigecycline, trimethoprim-sulfamethoxazole, and vancomycin. Information for the newer antibiotics (linezolid, quinupristin-dalfopristin, tigecycline, and daptomycin) was limited. Despite heterogeneity in the data for the older antibiotics (clindamycin, rifampin, tetracyclines, trimethoprim-sulfamethoxazole, and vancomycin), all appear to be relatively safe in the minimal quantities nursing infants ingest through breast milk. Although the risk to infants seems to be relatively low for most of the agents we explored, the paucity of data indicates a need for close monitoring of breastfed infants whose mothers are receiving an antibiotic for an MRSA skin and soft tissue infection.
Jennifer A Mitrano; Linda M Spooner; Paul Belliveau
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Pharmacotherapy     Volume:  29     ISSN:  1875-9114     ISO Abbreviation:  Pharmacotherapy     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-24     Completed Date:  2009-12-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8111305     Medline TA:  Pharmacotherapy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1103-9     Citation Subset:  IM    
Department of Pharmacy Practice, School of Pharmacy, Massachusetts College of Pharmacy and Health Sciences, Worcester, Massachusetts 01608, USA.
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MeSH Terms
Anti-Bacterial Agents / classification,  metabolism*,  therapeutic use
Breast Feeding / adverse effects
Clinical Trials as Topic
Lactation / drug effects*
Methicillin-Resistant Staphylococcus aureus / drug effects*
Staphylococcal Infections / drug therapy*,  microbiology
Staphylococcus aureus / drug effects*
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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