Ampicillin Pregnancy and Breastfeeding Warnings
Ampicillin Pregnancy Warnings
A case report of the prophylactic use of ampicillin to reduce the chances of miscarriage secondary to group B streptococci infection in a high risk patient, has been described in the medical literature. A 38-year-old patient with a past history of 3 prior pregnancy losses due to second trimester chorioamnionitis, was treated prophylactically with oral ampicillin in an attempt to carry her fourth pregnancy to term. Beginning at 14 weeks of gestation, the patient received amoxicillin, 250 mg orally four times a day for the first 10 days of each calendar month. Because the patient also had diabetes, the obstetrician performed a cesarean section at 40 weeks of gestation, delivering a healthy, 3630 g male infant whose Apgar scores at 1 and 5 minutes were 9 and 9.
Ampicillin has been assigned to pregnancy category B by the FDA. There are no controlled data in human pregnancy. However, the majority of retrospective data available indicate that ampicillin is not likely to be a human teratogen. Ampicillin is only recommended for use during pregnancy when benefit outweighs risk.
Ampicillin Breastfeeding Warnings
Ampicillin is excreted into human milk in small amounts. Candidiasis and diarrhea in the nursing infant have been reported, although a causal relationship was not established. Sensitization of the infant may occur. The American Academy of Pediatrics considers some other penicillins (amoxicillin, ticarcillin) to be compatible with breast-feeding. The manufacturer recommends that caution be used when administering ampicillin to nursing women.
References for pregnancy information
- Marinoff DN, Chinn A "Preventing recurrent second trimester group B streptococcus chorioamnionitis by intermittent prophylactic ampicillin." Obstet Gynecol 98(5 Pt 2) (2001): 918-9
- Czeizel AE, Rockenbauer M, Sorensen HT, Olsen J "A population-based case-control teratologic study of ampicillin treatment during pregnancy." Am J Obstet Gynecol 185 (2001): 140-7
- "Product Information. Polycillin (ampicillin)." Apothecon Inc, Plainsboro, NJ.
References for breastfeeding information
- Campbell AC, McElnay JC, Passmore CM "The excretion of ampicillin in breast milk and its effect on the suckling infant." Br J Clin Pharmacol 31 (1991): p230
- Matheson I, Samseth M, Sande HA "Ampicillin in breast milk during puerperal infections." Eur J Clin Pharmacol 34 (1988): 657-9
- "American Academy of Pediatrics. Committee on Drugs. The transfer of drugs and other chemicals into human milk." Pediatrics 108 (2001): 776-89
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