Last update: Aug. 22, 2019
Not risky for breastfeeding or infant.
Aminoglycoside antibacterial indicated in serious infections, usually with another antibiotic.
Administered intravenously or intramuscularly in one or two daily doses.
It is also used topically, cutaneously, ophthalmologically or otologically.
It is excreted in breastmilk in insignificant quantities (Celiloglu 1994, Boda 1990, Ito 1970).
Plasma levels of infants of mothers treated with gentamicin were zero (Ito 1970) or very low (Celiloglu 1994), lower than the recommended trough level in the monitoring of gentamicin treatment.
No problems have been observed in infants of mothers treated with gentamicin, except for a case of bloody stools in a newborn whose mother was given clindamycin and gentamicin (Mann 1980) and a two-month-old infant who presented transient urticaria after the mother took amoxicillin-clavulanic and gentamicin to treat mastitis (Cherif 2009).
Gentamicin, like all other aminoglycosides, has very low oral bioavailability (Briggs 2017, Chin 200, Fulton 1992), which impedes transfer from breastmilk to infant plasma, except in premature infants and the immediate neonatal period when there may be greater intestinal permeability (Nelson 1972).
t is important to take into account possible false negative cultures in febrile infants whose mothers take antibiotics, as well as the possibility of gastroenteritis due to altered intestinal flora (Briggs 2017, Arbex 2010, Ito 1993).
The small dose and the low plasma absorption of topical nasal, ophthalmological, otological and dermatological preparations prevent its transfer to breastmilk in significant amounts (Niebyl 1992).
Expert authors consider the use of this medication during breastfeeding to be safe (Hale 2019, Biggs 2017, Rowe 2013, Schaefer 2007, Nahum 2006, Mahadevan 2006).
American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).
List of WHO essential medicines: compatible with breastfeeding (WHO / UNICEF 2002).
We do not have alternatives for Gentamicin Sulfate since it is relatively safe.
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
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