Related Experiment Video

Updated: Jun 24, 2026

Assay Development for High-Throughput Drug Screening Against Mycobacteria
07:50

Assay Development for High-Throughput Drug Screening Against Mycobacteria

Published on: October 25, 2024

The safety of macrolides during lactation

L H Goldstein1, M Berlin, L Tsur

  • 1Clinical Pharmacology Service, Haemek Medical Center, Afula, Bruce Rappaport School of Medicine, Technion, Haifa, Israel. Goldstein_le@clalit.org.il

Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine
|April 16, 2009
PubMed
Abstract

Insights

Macrolide antibiotics are generally safe for breastfed infants, with comparable adverse reactions to amoxicillin. This study found no association between macrolide exposure via breastmilk and pyloric stenosis in infants.

Area of Science:

  • Pediatrics
  • Pharmacology
  • Neonatal Care

Background:

  • Infantile macrolide exposure linked to hypertrophic pyloric stenosis.
  • Potential macrolide-motilin receptor interaction implicated.
  • Concerns exist regarding macrolide transfer via breastmilk.

Purpose of the Study:

  • Assess the safety of macrolide antibiotics during lactation.
  • Evaluate the risk of adverse reactions in breastfed infants.
  • Investigate the association between maternal macrolide use and infant pyloric stenosis.

Main Methods:

  • Prospective, controlled observational study.
  • Compared infants exposed to macrolides (erythromycin, azithromycin, clarithromycin, roxithromycin) with those exposed to amoxicillin via breastmilk.
  • Monitored infants for adverse reactions.

Main Results:

  • Comparable rates of minor adverse reactions (12.7% macrolides vs. 8.3% amoxicillin).
  • Adverse reactions included rash, diarrhea, loss of appetite, and somnolence.
  • No statistically significant association found between macrolide type and adverse reactions.

Conclusions:

  • Macrolide and amoxicillin exposure during breastfeeding showed similar rates of minor infant adverse reactions.
  • Macrolide exposure via breastmilk was not associated with pyloric stenosis in this cohort.
  • Larger prospective studies are needed to confirm these findings.

Related Concept Videos

Clinical Significance of Antibiotic Resistance01:25

Clinical Significance of Antibiotic Resistance

Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...
Mechanism of Antibiotic Resistance in MRSA01:25

Mechanism of Antibiotic Resistance in MRSA

Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and acquisition...
Microbiota Modulation by Antibiotics01:21

Microbiota Modulation by Antibiotics

Antibiotics have revolutionized modern medicine by saving countless lives from bacterial infections. However, their widespread use has inadvertently harmed the delicate balance of the human gut microbiota. The gut microbiota, a complex community of bacteria, archaea, viruses, and fungi, plays a vital role in regulating metabolism, immune responses, and maintaining intestinal health. Antibiotics, especially broad-spectrum types, disrupt this ecosystem by eradicating both harmful and beneficial...
Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics01:23

Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics

Respiratory symptoms, such as congestion and cough, commonly accompany respiratory tract conditions. Various medications, such as antitussives, expectorants, and mucolytics, play crucial roles in providing relief.
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla.  Benzonatate operates peripherally within the respiratory tract by anesthetizing...
Inhibitors of Bacterial Protein Synthesis01:25

Inhibitors of Bacterial Protein Synthesis

Aminoglycosides constitute a highly potent class of bactericidal antibiotics that exert their antimicrobial effects by targeting the bacterial ribosome, specifically disrupting protein synthesis. These polycationic molecules consist of amino-modified sugars linked via glycosidic bonds to an aminocyclitol core such as 2-deoxystreptamine or streptamine. Their strong positive charges facilitate tight binding to the negatively charged phosphate backbone of ribosomal RNA (rRNA), primarily at the 16S...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...