From the FDA Drug Label
Nursing Mothers: It is not known whether topically applied ciprofloxacin is excreted in human milk. However, it is known that orally administered ciprofloxacin is excreted in the milk of lactating rats and oral ciprofloxacin has been reported in human breast milk after a single 500 mg dose. Caution should be exercised when Ciprofloxacin ophthalmic solution 0. 3% is administered to a nursing mother. The safest antibacterial eyedrop to use in breast-feeding mothers cannot be determined from the provided information, as the excretion of ciprofloxacin in human milk after topical application is unknown 1. Caution should be exercised when using Ciprofloxacin ophthalmic solution 0.3% in nursing mothers.
From the Research
The safest antibacterial eyedrops for breastfeeding mothers are typically erythromycin ophthalmic ointment (0.5%) or polymyxin B-trimethoprim drops, as they have minimal systemic absorption when applied topically to the eye, resulting in very little entering the bloodstream and even less reaching breast milk 2.
Key Considerations
- For bacterial conjunctivitis, apply erythromycin ointment 1 cm into the lower eyelid 2-4 times daily for 7-10 days, or polymyxin B-trimethoprim drops 1-2 drops every 3 hours (while awake) for 7-10 days.
- Other options like tobramycin, gentamicin, or ciprofloxacin are also considered compatible with breastfeeding but are typically reserved for more severe infections or when first-line treatments aren't effective.
- These medications are considered safe because the topical route of administration results in negligible systemic absorption, and the compounds are generally too large to pass significantly into breast milk.
- Always complete the full course of treatment even if symptoms improve quickly to prevent recurrence or antibiotic resistance.
Supporting Evidence
- A study published in 2023 2 emphasizes the importance of cautious drug administration during pregnancy and breastfeeding, highlighting the need for individual treatment and thorough assessment of the disease extent.
- Another study from 2015 3 compared the resistance patterns of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible Staphylococcus aureus (MSSA) keratitis isolates with common topically applied ophthalmic antimicrobials, providing insights into the effectiveness of various antibiotics.
Treatment Approach
- Erythromycin ophthalmic ointment (0.5%) and polymyxin B-trimethoprim drops are recommended as first-line treatments due to their safety profile and effectiveness in treating bacterial conjunctivitis.
- It is essential to follow the recommended dosage and treatment duration to ensure the infection is fully cleared and to minimize the risk of antibiotic resistance.
- Breastfeeding mothers should consult their healthcare provider before starting any medication, including antibacterial eyedrops, to discuss the potential risks and benefits and determine the best course of treatment.