Antibiotic (Cephalosporin)
PREGNANCY RECOMMENDATION: Compatible
BREASTFEEDING RECOMMENDATION: Compatible
PREGNANCY SUMMARY
No detectable teratogenic risk with cephalosporin antibiotics was found in a large 2001 study (see Cephalexin).
FETAL RISK SUMMARY
No reports describing the use of cefpodoxime in human pregnancy have been located. It is an oral, semisynthetic cephalosporin antibiotic. Reproduction studies found no evidence in rats of impaired fertility or reproductive performance or, in rats and rabbits, of embryo toxicity or teratogenicity, at doses up to two times the human dose based on BSA (1).
BREASTFEEDING SUMMARY
According to the manufacturer, low concentrations of cefpodoxime are excreted into human milk (1). Following 200-mg oral doses administered to three women, milk concentrations, as a percentage of concomitant serum levels, 4 hours after the dose were 0%, 2%, and 6%, respectively, and at 6 hours, 0%, 9%, and 16%, respectively. Although not specifically stated for these three women, mean serum concentrations in fasted adults after a 200-mg dose were 2.2 mcg/mL at 2 and 3 hours (peak levels), 1.8 mcg/mL at 4 hours, and 1.2 mcg/mL at 6 hours (1).
In spite of these low levels, three potential problems exist for the nursing infant exposed to cefpodoxime in milk: modification of bowel flora, direct effects on the infant, and interference with the interpretation of culture results if a fever workup is required. Although not specifically listing cefpodoxime, the American Academy of Pediatrics classifies other cephalosporin antibiotics as compatible with breastfeeding (for example, see Cefadroxil and Cefazolin).
Reference
1.Product information. Vantin. Pharmacia & Upjohn Company, 1997.