Safety in Lactation: Macrolides

Sarah Fenner, Acting Co-Director, Midlands and East Medicines Advice Service (Midlands site) & UK Drugs in Lactation Advisory ServicePublished

Epidemiologic evidence indicates that the risk of hypertrophic pyloric stenosis in infants might be increased by use of maternal macrolides, especially in infants exposed in the first 2 weeks after birth. This risk may be greater with erythromycin.
Monitor infant for gastro-intestinal disturbances and oral candida infection, especially if used for prolonged periods or in high doses, although these effects are unlikely to occur.
Choice of drug and alternatives may be directed by local antimicrobial policy.