Zosyn Use During Breastfeeding
Zosyn (piperacillin/tazobactam) can be used during breastfeeding, as piperacillin is excreted in breast milk at low concentrations similar to other penicillins, which are classified as compatible with breastfeeding. 1
Safety Profile and Evidence
Piperacillin, the primary component of Zosyn, belongs to the penicillin class, which is consistently classified as "compatible" with breastfeeding across multiple international guidelines. 2
The FDA drug label confirms that piperacillin is excreted in human milk, though tazobactam concentrations in breast milk have not been specifically studied. 1
Penicillins and aminopenicillins are present in breast milk at low concentrations, making them among the safest antibiotic options for breastfeeding mothers. 2
Clinical Recommendations
The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for Zosyn, as stated in the FDA label. 1
Breastfeeding does not need to be interrupted when Zosyn is prescribed, following the same principles applied to other compatible penicillin antibiotics. 2
Infant Monitoring Considerations
Monitor the breastfed infant for gastrointestinal effects, including diarrhea or changes in stool pattern, due to potential alteration of intestinal flora. 2, 3
Watch for signs of candidiasis or other mild GI disturbances, though serious adverse events from penicillin exposure through breast milk are rare. 2
Be aware that antibiotics in breast milk could potentially cause falsely negative cultures if the breastfed infant develops fever requiring evaluation. 2, 3
Important Caveats
The safety profile assumes a full-term, healthy infant receiving standard recommended doses of Zosyn for appropriate duration. 2
If the infant is premature, jaundiced, or has other risk factors, closer monitoring is warranted, though this applies to all antibiotic use during breastfeeding rather than being specific to Zosyn. 4
The small amounts of antibiotic in breast milk should not be considered therapeutic for the infant—if the baby develops an infection, they require their own appropriate dosing. 2