Last update Aug. 22, 2019

Kanamycin

Compatible

Safe substance and/or breastfeeding is the best option.

Aminoglycoside antibacterial active on Gram positive, Gram negative and Mycobacterium tuberculosis bacteria.
Given its nephrological and otological toxicity, its most frequent current use is topically (dermal or intestinal) although it is still used in some countries intravenously.

It is excreted in breastmilk in moderate quantities (Lactmed 2018: Amiraslanova 1985, Matsuda 1984, Vorherr 1974), and even large quantities (Briggs 2017, Tran 1998, O'Brien 1974). An infant exposed during pregnancy and breastfeeding to kanamycin and other anti-tuberculosis drugs did not present clinical problems due to the medication (Drobac 2005).

Kanamycin, like all other aminoglycosides, has very low oral bioavailability (Briggs 2017, Chin 2001), which impedes transfer from breastmilk to infant plasma, except in premature infants and the immediate neonatal period when there may be greater intestinal permeability.

It 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).

American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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Other names

Kanamycin is also known as


Kanamycin in other languages or writings:

Groups

Kanamycin belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Kanamycin in its composition:

List of 6 tradenames

Pharmacokinetics

Variable Value Unit
Oral Bioavail. < 1 %
Molecular weight 485 daltons
Protein Binding 0 %
VD 0.2-0.3 l/Kg
pKa 7.2 -
Tmax 1 hours
T½ 3 hours
M/P ratio 0.05 - 0.4 -
Theoretical Dose 0.385 mg/Kg/d
Relative Dose 5.1 - 7.7 %
Ped.Relat.Dose 2.6 %

References

  1. LactMed. Kanamycin. Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Abstract Full text (link to original source)
  2. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  3. Drobac PC, del Castillo H, Sweetland A, Anca G, Joseph JK, Furin J, Shin S. Treatment of multidrug-resistant tuberculosis during pregnancy: long-term follow-up of 6 children with intrauterine exposure to second-line agents. Clin Infect Dis. 2005 Jun 1;40(11):1689-92. Epub 2005 Apr 18. Abstract Full text (link to original source) Full text (in our servers)
  4. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  5. Chin KG, McPherson CE 3rd, Hoffman M, Kuchta A, Mactal-Haaf C. Use of anti-infective agents during lactation: Part 2--Aminoglycosides, macrolides, quinolones, sulfonamides, trimethoprim, tetracyclines, chloramphenicol, clindamycin, and metronidazole. J Hum Lact. 2001 Feb;17(1):54-65. Abstract
  6. Tran JH, Montakantikul P. The safety of antituberculosis medications during breastfeeding. J Hum Lact. 1998 Dec;14(4):337-40. Review. Abstract
  7. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993 May;168(5):1393-9. Abstract
  8. Amiraslanova LA, Emel'ianova AI, Fursova SA, Rukhadze TG. [Various characteristics of the pharmacokinetics of ampicillin, kanamycin and cefuroxime in puerperants with endometritis]. Akush Ginekol (Mosk). 1985 Oct;(10):14-7. Russian. No abstract available. Abstract
  9. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol. 1984;5(2):57-60. Abstract
  10. Vorherr H. Drug excretion in breast milk. Postgrad Med. 1974 Oct;56(4):97-104. Review. No abstract available. Abstract
  11. O'Brien TE. Excretion of drugs in human milk. Am J Hosp Pharm. 1974 Sep;31(9):844-54. Review. Abstract

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