Is Cefepime safe while breastfeeding?
Here is what LactMed, the Drugs and Lactation Database published by the U.S. National Institute of Child Health and Human Development (NICHD), reports about Cefepime. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Although no published information is available on the use of cefepime during breastfeeding, the levels in breastmilk appear to be low and cephalosporins are generally not expected to cause serious adverse effects in breastfed infants. No human information is available on zidebactam (a component of Zaynich) in breastmilk. Occasional disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush, has been reported with beta-lactam antibiotics, but these effects have not been adequately evaluated. Cefepime is acceptable in nursing mothers. The combination of cefepime and zidebactam has not been studied in humans during breastfeeding, but the adverse effects are probably similar to those of cefepime.
Effects on the breastfed infant
Relevant published information was not found as of the revision date.
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. The manufacturer reports that the mean concentration of cefepime in breastmilk in 9 healthy women was about 0.5 mcg/mL during the first 8 hours, following a single intravenous dose of 1 gram, then undetectable between 12 and 24 hours. The mean cumulative breast milk excretion of cefepime over 24 hours was 0.01% of the administered dose. A nursing infant consuming approximately 1000 mL of human milk per day would receive approximately 0.5 mg of cefepime per day. This is consistent with the low levels of other cephalosporins in breastmilk.
Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
“No published information” means the studies do not exist yet — not that Cefepime is known to be harmful, and not that it is known to be safe. Your prescriber or pharmacist can weigh your baby's age and whether a better-studied alternative would do the same job. Worth asking before stopping a medicine you need.
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Cefepime” (LM46). LactMed on NCBI Bookshelf. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.