Lactating mothers who have bacterial or other pathogen infections will inevitably need to use antibiotics, some antibiotics can be used as an option, antibiotics are prescription drugs, how to use them, of course, you need to see your doctor's advice.
1.Penicillins and cephalosporins.
With the exception of a few reports of diarrhoea in breastfed infants, penicillins and cephalosporins have little adverse effect on the child and are usually preferred if the condition requires it.
2.Macrolides.
Mainly erythromycin and azithromycin. Erythromycin is present in breast milk at higher concentrations than plasma, and when given intravenously, its concentration in breast milk is even higher. There have been anecdotes of pyloric stenosis caused by erythromycin ingestion in breast milk in breastfed infants, although the American Academy of Pediatrics considers erythromycin to be safe during lactation. Azithromycin has a long half-life and can accumulate in breast milk, but no adverse effects have been reported in breastfed infants. Thus, erythromycin is preferred when macrolide antibiotics are required during lactation, and there is no need to interrupt breastfeeding if erythromycin is contraindicated and other agents are used.
3.Sulfonamides.
Sulfonamides compete with bilirubin for albumin and are generally not used in the neonatal period. Sulfonamides should also not be used in nursing mothers of infants with G6PD deficiency or hyperbilirubinemia.
4.Tetracyclines.
Tetracycline can cause tooth staining and abnormal bone growth. Because tetracycline binds to calcium in breast milk and is rarely absorbed by infants, the American Academy of Pediatrics considers that tetracycline can be used for a short period of time during lactation, but that long-term use of tetracycline should be discouraged for mothers. Doxycycline has a long half-life and causes less problems with tooth discoloration and abnormal bone growth when used directly in children than tetracycline, however, doxycycline binds less to calcium than tetracycline and may in fact be more absorbed in infants than tetracycline, although it is not strictly contraindicated and should be avoided with long-term use.
5.Quinolones.
These drugs are associated with joint pathology in newborn animals and are not usually used in children. However, in recent years, many studies have re-evaluated its safety in children, and the incidence and severity of adverse effects do not appear to be higher than **. Among the quinolones, ofloxacin, ciprofloxacin, or levofloxacin may be the preferred choice for lactating mothers because of their low milk concentrations. Quinolones should not be used as the first line of action for breastfeeding mothers**, but breastfeeding can be done without interruption if quinolones are the only option.
6.Antifungal drugs.
Ketoconazole is an antifungal agent for fungal infections that is either topical or oral**. Although ketoconazole is lipophilic and weakly alkaline, it has a high protein binding rate and enters the breast milk in very low amounts. Ketoconazole can be safely used by lactating mothers. Fluconazole can be secreted through breast milk, and the concentration of milk is similar to that of plasma. If fluconazole 150 mg is used as a single dose, breastfeeding can be continued. After multiple doses or high-dose fluconazole, it is recommended to stop breastfeeding. Since fluconazole can also be used in neonates, the pros and cons of the drug can be weighed according to the clinical needs of the mother.
7.Anti-anaerobic drugs.
Metronidazole is an antibiotic and amoebicide drug, and the indication for use is trichomoniasis **inflammation and **inflammation caused by various anaerobic bacterial infections. Metronidazole should be avoided as much as possible during breastfeeding, but it is not an absolute contraindication to lactation. If the mother must apply metronidazole, a single dose (2 g) should be applied if possible, while the milk is pumped and discarded for 24 hours. After 6 months, the baby is well metabolized with metronidazole and can be used directly. Tinidazole is excreted in breast milk after 72 hours at a concentration similar to that in blood and should be contraindicated in lactating women. If medication is necessary, breastfeeding should be discontinued and breastfeeding should be delayed for 3 days.
8.Clindamycin and vancomycin.
Clindamycin is easily soluble in water, has a small molecular weight, and binds 60% to 90% to plasma proteins, which limit its distribution in milk. Breastfeeding women can continue breastfeeding with clindamycin. Vancomycin is a macromolecular substance that dissolves easily in water and binds about 55% to plasma proteins. Therefore, vancomycin does not easily enter the breast milk and can be safely applied by lactating mothers.