From the Guidelines
Amikacin is the safest aminoglycoside that can be given to a lactating mother for the treatment of a urinary tract infection (UTI), considering its higher susceptibility against certain bacterial strains compared to other aminoglycosides like gentamicin, as suggested by recent studies 1. When considering the treatment of UTIs in lactating mothers with aminoglycosides, it's crucial to weigh the potential benefits against the risks, including ototoxicity and nephrotoxicity.
- The use of aminoglycosides, such as amikacin, should be closely monitored for any adverse effects, and therapeutic drug monitoring (TDM) is recommended if available, especially with high doses 1.
- Aminoglycosides are poorly absorbed orally, which minimizes the risk to the nursing infant, as the amount that enters breast milk is very small and would not be significantly absorbed by the infant.
- However, due to potential side effects and the route of administration, aminoglycosides are not typically the first-line treatment for UTIs in lactating women; other classes of antibiotics are usually preferred unless specific culture results indicate the need for an aminoglycoside.
- Given the higher susceptibility of certain bacterial strains to amikacin compared to gentamicin, as observed in some regions 1, amikacin could be considered a safer option for lactating mothers when an aminoglycoside is necessary.
- It is essential to follow local antimicrobial susceptibility testing results to guide the appropriate prescription of aminoglycosides.
From the Research
Aminoglycosides for UTI in Lactating Mothers
- There is limited information available on the use of aminoglycosides in lactating mothers for the treatment of urinary tract infections (UTIs) 2.
- Aminoglycosides, such as gentamicin, are generally considered safe for use in non-pregnant, non-lactating women with UTIs 3, 4, 5, 6.
- However, the use of aminoglycosides during lactation is not well-studied, and their safety in this population is not well-established 2.
- Gentamicin is an aminoglycoside antibiotic that has been used to treat UTIs in various patient populations, including infants and children 3, 5.
- Studies have shown that gentamicin is effective in treating UTIs, but its use is associated with potential risks of nephrotoxicity and ototoxicity 4, 6.
- The safety of gentamicin in lactating mothers is not well-established, and its use in this population should be approached with caution 2.
Gentamicin as a Potential Option
- Gentamicin may be a potential option for the treatment of UTIs in lactating mothers, but its use should be carefully considered and monitored 3, 4, 5, 6.
- The dosage and duration of gentamicin treatment should be carefully selected to minimize the risk of adverse effects 3, 5.
- Lactating mothers should be closely monitored for signs of gentamicin toxicity, such as nephrotoxicity and ototoxicity 4, 6.
- Alternative antibiotics may be considered for the treatment of UTIs in lactating mothers, depending on the specific clinical circumstances and the susceptibility of the infecting organism 2.