MOXALACTAM

Fetal Risk Summary

Moxalactam is a cephalosporin antibiotic. No controlled studies on its use in pregnancy have been located. The drug crosses the placenta to the fetus, producing a mean peak level at 1 hour in the cord blood of 38.4 µg/mL following a 1-g IV dose (R. Kammer, personal communication, Eli Lilly and Company, 1985). Peak amniotic fluid levels of 10.3 µg/mL occurred at 7.5 hours.

Breast Feeding Summary

Moxalactam is excreted into breast milk (1). In eight women receiving 2 g every 8 hours, mean daily concentrations of the antibiotic varied from 1.56 to 3.66 µg/mL, representing a daily dose of 0.86–2.01 mg. Because moxalactam is acid stable, the authors cautioned that colonization of the infant's bowel with gram-positive organisms could occur, resulting in a risk for enterocolitis (1). Because of this theoretical risk, they advised against breast feeding if the mother was being treated with moxalactam. The American Academy of Pediatrics considers moxalactam to be compatible with breast feeding (2).

References

1. Miller RD, Keegan KA, Thrupp LD, Brann J. Human breast milk concentration of moxalactam. Am J Obstet Gynecol 1984;148:348–9.
2. Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:137–50.