From the Guidelines
Breastfeeding mothers can generally use topical eye antibiotics for bacterial conjunctivitis, as these medications have minimal systemic absorption and do not significantly enter breast milk. The most recent and highest quality study, 1, published in 2024, suggests that mild bacterial conjunctivitis is usually self-limited and can resolve spontaneously without specific treatment, but topical antibacterial therapy can lead to earlier clinical and microbiological remission. Common options for topical eye antibiotics include erythromycin ophthalmic ointment, polymyxin B-trimethoprim drops, or ciprofloxacin drops, typically applied to the affected eye(s) 3-4 times daily for 5-7 days.
Key Considerations
- When applying topical eye antibiotics, it is essential to wash hands thoroughly before and after, pull down the lower eyelid to create a small pocket, apply the prescribed amount, close the eye for 1-2 minutes to allow absorption, and wipe away excess with a clean tissue.
- If symptoms do not improve within 48-72 hours, worsen, or if vision changes or severe pain develop, it is crucial to contact a healthcare provider.
- To prevent spreading the infection to others or the baby, it is recommended to avoid sharing towels, washcloths, or pillowcases.
Treatment Options
- For moderate to severe bacterial conjunctivitis, the choice of antibiotic may be guided by laboratory test results, and options like vancomycin may be considered, as mentioned in 1.
- In cases where access to antibiotics is limited, povidone-iodine 1.25% ophthalmic solution may be an alternative, as suggested in 1. It is essential to note that the use of topical antibiotics should be guided by the severity of the conjunctivitis and the potential risks and benefits, as highlighted in 1 and 1.
From the FDA Drug Label
In nursing women a single 200 mg oral dose resulted in concentrations of ofloxacin in milk which were similar to those found in plasma. It is not known whether ofloxacin is excreted in human milk following topical ophthalmic administration Because of the potential for serious adverse reactions from ofloxacin in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Breastfeeding mothers can use topical eye antibiotics for bacterial conjunctivitis, but a decision should be made to either discontinue nursing or discontinue the drug, considering the importance of the drug to the mother, due to the potential for serious adverse reactions in nursing infants 2.
From the Research
Topical Eye Antibiotics for Bacterial Conjunctivitis in Breastfeeding Mothers
- The provided studies do not directly address the use of topical eye antibiotics for bacterial conjunctivitis in breastfeeding mothers 3, 4, 5, 6, 7.
- However, the studies discuss the treatment of bacterial conjunctivitis with topical antibiotics in general, which may be relevant to breastfeeding mothers.
- Topical antibiotics such as azithromycin or fluoroquinolones are commonly prescribed for bacterial conjunctivitis 4.
- The choice of antibiotic may depend on the causative pathogen and its antibiotic susceptibility profile 4, 6.
- It is essential to note that the safety of topical eye antibiotics during breastfeeding is not explicitly discussed in the provided studies.
Considerations for Breastfeeding Mothers
- Breastfeeding mothers should consult their healthcare provider before using any medication, including topical eye antibiotics.
- The healthcare provider can assess the individual situation and provide guidance on the safe use of topical eye antibiotics during breastfeeding.
- In general, topical antibiotics are considered safe for use during breastfeeding, as they are poorly absorbed systemically and are unlikely to affect the infant 3, 5, 7.