CEPHAPIRIN

Fetal Risk Summary

Cephapirin is a parenteral cephalosporin antibiotic. At term, following a 1-g IM dose, peak concentrations for maternal serum, cord serum and amniotic fluid were about 17 (0.5 hour), 10 (4 hours), and 13 µg/mL (6 hours), respectively (1). No data on the newborns were given. Cephalosporins are usually considered safe to use during pregnancy.

Breast Feeding Summary

Cephapirin is excreted into breast milk in low concentrations. A 1-g intravenous bolus dose given to six mothers produced peak milk levels at 1–2 hours averaging 0.49 µmg/mL (range 0.30–0.64 µmg/mL) (2). Mean milk:plasma ratios at 1, 2, and 3 hours were 0.068, 0.250, and 0.480, respectively. Even though these levels were 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 cephapirin, the American Academy of Pediatrics classifies other cephalosporin antibiotics as compatible with breast feeding (3).

References

1. Creatsas G, Pavlatos M, Lolis D, Kasharelis D. A study of the kinetics of cephapirin and cefalexin in pregnancy. Curr Med Res Opin 1980;7:43–6.
2. Kafetzis D, Siafas C, Georgakopoulos P, Papadatos CJ. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand 1981;70:285–8.
3. Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:137–50.