Summary of Use during Lactation

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.

Drug Levels

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.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

Ceftazidime, Ceftriaxone

Substance Name

Cefepime

CAS Registry Number

88040-23-7

Drug Class

Breast Feeding

Lactation

Milk, Human

Anti-Infective Agents

Antibacterial Agents

Cephalosporins