Cephapirin
Risk Factor: BM
Class: ANTI-INFECTIVES
/ Cephalosporins
Contents of this page:
Fetal Risk Summary
Breast Feeding Summary
References
Questions and Answers
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 g/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 12 hours averaging 0.49 mg/mL (range 0.300.64 mg/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
- Creatsas G, Pavlatos M, Lolis D, Kasharelis D. A study of the kinetics of cephapirin and cefalexin in pregnancy. Curr Med Res Opin 1980;7:436.
- Kafetzis D, Siafas C, Georgakopoulos P, Papadatos CJ. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand 1981;70:2858.
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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.
