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An antibacterial aminoglycoside used orally in the treatment of intestinal infestations by protozoa (giardia, amoeba and cryptosporidiosis) and by tapeworms. It is also administered orally to suppress intestinal flora prior to surgical interventions and encephalopathy and hepatic coma.
It is used topically in cutaneous leishmaniasis (Garnier 2002) and intramuscularly in visceral leishmaniasis (Musa 2010).
Since the last update we have not found published data on its excretion in breastmilk.
Its practically zero oral bioavailability (Kip 2018, Bissuel 1994) and cutaneous bioavailability (Ravis 2013) impede transfer to the mother’s plasma and therefore it is unlikely that it will be excreted in breastmilk in amounts that could be significant.
Still injected intramuscularly, its lack of lipid solubility (Kit 2018) and short half-life would greatly hinder excretion in breastmilk.
This same low oral bioavailability hinders transfer to infant plasma from breastmilk, except in premature babies and the immediate neonatal period when there may be increased intestinal permeability.
The possible negativity of cultures in febrile infants whose mothers take antibiotics should be taken into account, as well as the possibility of gastroenteritis due to alteration of the intestinal flora (Ito 1993).