Cefamandole
Risk Factor: BM
Class: ANTI-INFECTIVES
/ Cephalosporins
Contents of this page:
Fetal Risk Summary
Breast Feeding Summary
References
Questions and Answers
Fetal Risk Summary
Cefamandole is a parenteral, semisynthetic cephalosporin antibiotic. Reproduction studies in rats found no evidence of impaired fertility or fetal harm, including testicular toxicity, at doses up to approximately 5 times the human dose (1).
Although pregnant patients were excluded from clinical trials of cefamandole, one patient did receive the drug in the 1st trimester (J.T. Anderson, personal communication, Lilly Research Laboratories, 1981). No apparent adverse effects were noted in the newborn. Cephalosporins are usually considered safe to use during pregnancy (see other cephalosporins for published human experience).
Breast Feeding Summary
Cefamandole is excreted into breast milk in low concentrations. Following a 1-g IV dose, average milk levels in four patients ranged from 0.46 (1 hour) to 0.19 g/mL (6 hours) (J.T. Anderson, personal communication. Lilly Research Laboratories, 1981). The milk:plasma ratio at 1 hour was 0.02. No neonate information was given. Even though these levels are low, three potential problems exist for the nursing infant: modification of bowel flora, direct effects on the infant, and interference with the interpretation of culture results if a fever workup is required. Although not specifically listing cefamandole, the American Academy of Pediatrics classifies other cephalosporin antibiotics as compatible with breast feeding (2).
References
- Product information. Mandol. Eli Lilly and Company, 1997.
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Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:13750.
