Last update: Aug. 2, 2016

Erythromycin

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

Excreted in very low levels into breast milk.

Commonly used for pediatric treatment of small babies; it is very well tolerated by infants.

Erythromycin is a macrolide that has been related to hypertrophic pyloric stenosis after early exposition through the breast milk. Avoiding its use in the first post-partum month would be a cautious measure.

Be aware of the possibility of false negative results of bacterial cultures when the mother is on antibiotics. Also, diarrheal disease due to imbalance of intestinal flora is possible

Small doses used for treatment of dermatologic and ophthalmologic conditions, together with a very low level in the mother’s plasma make very unlikely a significant excretion into breast milk.

Topically used Erythromycin is safe while breastfeeding. Systemic treatments would be safer after the first month of life.

The American Academy of Pediatrics rates it usually compatible with breastfeeding.

List of Essential Medicines WHO 2002: Compatible with breastfeeding.

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

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Other names

Erythromycin in other languages or writings:

Groups

Erythromycin belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Erythromycin in its composition:

List of 9 tradenames

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 75 %
Molecular weight 734 daltons
Protein Binding 70 - 95 %
Tmax 1 - 4 hours
T1/2 1,5 - 2,5 hours
M/P ratio 0,9 - 1,6 -
Theoretical Dose 0,5 mg/Kg/d
Relative Dose 1,5 %
Relat.Ped.Dose 1,3 - 2, 5 %

References

  1. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014 Mar;70(3):417.e1-10; quiz 427. Abstract
  2. Kong YL, Tey HL. Treatment of acne vulgaris during pregnancy and lactation. Drugs. 2013 Jun;73(8):779-87. Abstract
  3. ASGE Standard of Practice Committee, Shergill AK, Ben-Menachem T, Chandrasekhara V, Chathadi K, Decker GA, Evans JA, Early DS, Fanelli RD, Fisher DA, Foley KQ, Fukami N, Hwang JH, Jain R, Jue TL, Khan KM, Lightdale J, Pasha SF, Sharaf RN, Dominitz JA, Cash BD. Guidelines for endoscopy in pregnant and lactating women. Gastrointest Endosc. 2012 Abstract Full text (link to original source) Full text (in our servers)
  4. Goldstein LH, Berlin M, Tsur L, Bortnik O, Binyamini L, Berkovitch M. The safety of macrolides during lactation. Breastfeed Med. 2009 Dec;4(4):197-200. Abstract
  5. Ng PC. Use of oral erythromycin for the treatment of gastrointestinal dysmotility in preterm infants. Neonatology. 2009 Abstract Full text (in our servers)
  6. Maheshwai N. Are young infants treated with erythromycin at risk for developing hypertrophic pyloric stenosis? Arch Dis Child. 2007 Abstract Full text (link to original source) Full text (in our servers)
  7. Bar-Oz B, Bulkowstein M, Benyamini L, Greenberg R, Soriano I, Zimmerman D, Bortnik O, Berkovitch M. Use of antibiotic and analgesic drugs during lactation. Drug Saf. 2003 Abstract
  8. Noti A, Grob K, Biedermann M, Deiss U, Brüschweiler BJ. Exposure of babies to C15-C45 mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003 Abstract
  9. Sørensen HT, Skriver MV, Pedersen L, Larsen H, Ebbesen F, Schønheyder HC. Risk of infantile hypertrophic pyloric stenosis after maternal postnatal use of macrolides. Scand J Infect Dis. 2003;35(2):104-6. Abstract
  10. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  11. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  12. Chin KG, McPherson CE 3rd, Hoffman M, Kuchta A, Mactal-Haaf C. Use of anti-infective agents during lactation: Part 2--Aminoglycosides, macrolides, quinolones, sulfonamides, trimethoprim, tetracyclines, chloramphenicol, clindamycin, and metronidazole. J Hum Lact. 2001 Feb;17(1):54-65. Abstract
  13. [No authors listed] Erythromycin-induced pyloric stenosis in infants. Prescrire Int. 2001 Abstract
  14. van Hoogdalem EJ. Transdermal absorption of topical anti-acne agents in man; review of clinical pharmacokinetic data. J Eur Acad Dermatol Venereol. 1998 Abstract
  15. 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 Abstract
  16. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993 May;168(5):1393-9. Abstract
  17. Fulton B, Moore LL. Antiinfectives in breastmilk. Part II: Sulfonamides, tetracyclines, macrolides, aminoglycosides and antimalarials. J Hum Lact. 1992 Dec;8(4):221-3. Review. No abstract available. Abstract
  18. Sytnik SI. [Antibiotic sensitivity of Staphylococci populating the breast skin of nursing women]. Antibiot Khimioter. 1989 Abstract
  19. Periti P, Mazzei T, Mini E, Novelli A. Clinical pharmacokinetic properties of the macrolide antibiotics. Effects of age and various pathophysiological states (Part I). Clin Pharmacokinet. 1989 Abstract
  20. Stang H. Pyloric stenosis associated with erythromycin ingested through breastmilk. Minn Med. 1986 Abstract
  21. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol. 1984;5(2):57-60. Abstract
  22. Knowles JA. Effects on the infant of drug therapy in nursing mothers. Drug Ther (NY). 1973 Abstract

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