Risk Factor: C
Class: Anti-infectives/ Antibiotics/anti-infectives
Fetal Risk Summary
Paromomycin is an aminoglycoside antibiotic used for intestinal amebiasis. No reports linking this agent with congenital malformations have been located. Because it is poorly absorbed, with almost 100% of an oral dose excreted unchanged in the feces, little if any of the drug will reach the fetus.
Two women, one at 13 weeks’ and the other at 23 weeks’ gestation, were treated for a symptomatic intestinal infection caused by Giardia lamblia (1). Both delivered normal female infants at term. A 1985 review of intestinal parasites and pregnancy concluded that treatment of the pregnant patient should only be considered if the parasite is causing clinical disease or may cause public health problems (2). When indicated, paromomycin was recommended for the treatment of protozoan infections caused by G. lamblia and Entamoeba histolytica, and for tapeworm infestations occurring during pregnancy (2).
Breast Feeding Summary
Paromomycin excretion in human milk is not expected because the drug is not absorbed into the systemic circulation after oral dosing. Following parenteral administration to lactating ewes, only 0.018% of the dose was recovered from the milk during a 12-hour period (3). The poor lipid solubility of the antibiotic limited its passage into milk (3).
- Kreutner AK, Del Bene VE, Amstey MS. Giardiasis in pregnancy. Am J Obstet Gynecol 1981;140:895901.
- D’Alauro F, Lee RV, Pao-In K, Khairallah M. Intestinal parasites and pregnancy. Obstet Gynecol 1985;66:63943.
- Ziv G, Sulman FG. Distribution of aminoglycoside antibiotics in blood and milk. Res Vet Sci 1974;17:6874.