Summary of Use during Lactation

No information is available on the clinical use of alatrofloxacin during breastfeeding. Fluoroquinolones have traditionally not been used in infants because of concern about adverse effects on the infants' developing joints. However, recent studies indicate little risk.[1,2] The calcium in milk might prevent absorption of the small amounts of fluoroquinolones in milk,[3] but insufficient data exist to prove or disprove this assertion. Use of alatrofloxacin is acceptable in nursing mothers with monitoring of the infant for possible effects on the gastrointestinal flora, such as diarrhea or candidiasis (thrush, diaper rash). However, it is preferable to use an alternate drug for which safety information is available.

Drug Levels

Maternal Levels. The manufacturer reports that trovafloxacin was found in the breast milk of three lactating subjects. The average measurable breast milk concentration was 0.8 mcg/mL (range 0.3 to 2.1 mcg/mL) after a single intravenous alatrofloxacin dose equivalent to 300 mg of trovafloxacin. Further details on the study are not available.

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

Ciprofloxacin, Levofloxacin

References

1.

Gürpinar AN, Balkan E, Kiliç N, et al. The effects of a fluoroquinolone on the growth and development of infants. J Int Med Res 1997;25:302-6. [PubMed: 9364293]

2.

van den Oever HL, Versteegh FG, Thewessen EA, et al. Ciprofloxacin in preterm neonates: Case report and review of the literature. Eur J Pediatr 1998;157:843-5. [PubMed: 9809826]

3.

Fleiss PM. The effect of maternal medications on breast-feeding infants. J Hum Lact 1992;8:7. [PubMed: 1558663]

Substance Name

Alatrofloxacin

CAS Registry Number

157182-32-6

Drug Class

Breast Feeding

Lactation

Milk, Human

Anti-infective Agents

Antibacterial Agents

Quinolones

Fluoroquinolones