Drugs in Pregnancy and Lactation: Tenth Edition

PAROMOMYCIN

Antibiotic (Aminoglycoside)/Amebicide

PREGNANCY RECOMMENDATION: Limited Human Data—Probably Compatible

BREASTFEEDING RECOMMENDATION: No Human Data—Probably Compatible

PREGNANCY SUMMARY

Paromomycin is an aminoglycoside antibiotic used for intestinal amebiasis. No reports linking this agent with congenital malformations have been located. Because it is poorly absorbed, with almost 100% of an oral dose excreted unchanged in the feces, little if any of the drug will reach the fetus.

FETAL RISK SUMMARY

Two women, one at 13 weeks’ and the other at 23 weeks’ gestation, were treated for a symptomatic intestinal infection caused by Giardia lamblia (1). Both delivered normal female infants at term. A 1985 review of intestinal parasites and pregnancy concluded that treatment of the pregnant patient should only be considered if the “parasite is causing clinical disease or may cause public health problems” (2). When indicated, paromomycin has been recommended for the treatment of protozoan infections caused by G. lamblia and Entamoeba histolytica and for tapeworm infestations occurring during pregnancy (2).

BREASTFEEDING SUMMARY

Paromomycin excretion in human milk is not expected as the drug is not absorbed into the systemic circulation after oral dosing.

References

1.Kreutner AK, Del Bene VE, Amstey MS. Giardiasis in pregnancy. Am J Obstet Gynecol 1981;140:895–901.

2.D’Alauro F, Lee RV, Pao-In K, Khairallah M. Intestinal parasites and pregnancy. Obstet Gynecol 1985;66:639–43.



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