Last update April 18, 2025

Vancomycin

Compatible

Safe product and/or breastfeeding is the best option.

Vancomycin is a glycopeptide antibacterial used intravenously every 6-12 hours in the treatment and prophylaxis of severe staphylococcal infections, especially methicillin-resistant Staphylococcus aureus (MRSA). Orally, it is used in the treatment of staphylococcal enterocolitis and antibiotic-associated colitis, including pseudomembranous colitis with Clostridium difficile overgrowth.

Its high molecular weight and large volume of distribution may explain why it is excreted in breast milk in a clinically insignificant amount (Reyes 1989), much lower than the dose used for newborn and infant infections.

In addition, its very low oral bioavailability, with no or negligible intestinal absorption (Rao 2011), makes it difficult to pass into the infant's plasma from ingested breast milk, except in premature infants and the immediate neonatal period, where there may be greater intestinal permeability.

Several medical societies and expert authors consider this medication safe for use during breastfeeding, which can be used in case of severe mastitis due to MRSA. (Hale, LactMed, van Wattum 2019, Amir 2014 and 2011, Mitrano 2009, Mahadevan 2006)

Alternatives

We do not have alternatives for Vancomycin since it is relatively safe.

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.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Vancomycin in other languages or writings:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. ≈ 0 %
Molecular weight 1449 daltons
Protein Binding 10 - 55 %
VD 0.4 - 1 l/Kg
pKa 9.89 -
4 - 6 hours
M/P ratio 1 -
Theoretical Dose 1.9 mg/Kg/d
Relative Dose 4.8 - 6.7 %
Ped.Relat.Dose 4.8 - 6.3 %

References

  1. LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consulted on April 16, 2024 Full text (link to original source)
  2. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on April 10, 2024 Full text (link to original source)
  3. van Wattum JJ, Leferink TM, Wilffert B, Ter Horst PGJ. Antibiotics and lactation: An overview of relative infant doses and a systematic assessment of clinical studies. Basic Clin Pharmacol Toxicol. 2019 Jan;124(1):5-17. Abstract
  4. Amir LH. y el Comité de protocolos de la Academy of Breastfeeding Medicine. Protocolo clínico de la ABM n.o 4: Mastitis, modi cado en marzo de 2014. Breastfeed Med. 2014;9(5):239-243. Abstract Full text (link to original source) Full text (in our servers)
  5. Amir LH; Academy of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol #4: Mastitis, Revised March 2014. Breastfeed Med. 2014;9(5):239-243. Abstract Full text (link to original source) Full text (in our servers)
  6. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Sep;40(9):684-90. Review. Abstract
  7. Rao S, Kupfer Y, Pagala M, Chapnick E, Tessler S. Systemic absorption of oral vancomycin in patients with Clostridium difficile infection. Scand J Infect Dis. 2011 Abstract
  8. Mitrano JA, Spooner LM, Belliveau P. Excretion of antimicrobials used to treat methicillin-resistant Staphylococcus aureus infections during lactation: safety in breastfeeding infants. Pharmacotherapy. 2009 Sep;29(9):1103-9. Abstract
  9. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006 Jul;131(1):283-311. Review. Abstract Full text (link to original source) Full text (in our servers)
  10. Reyes MP, Ostrea EM Jr, Cabinian AE, Schmitt C, Rintelmann W. Vancomycin during pregnancy: does it cause hearing loss or nephrotoxicity in the infant? Am J Obstet Gynecol. 1989 Abstract

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e-lactancia is a resource recommended by Academy of Breastfeeding Medicine - 2012 of United States of America

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