Vancomycin

Drug Levels and Effects:




Summary of Use during Lactation:


Limited information indicates that vancomycin produces low levels in milk and it would not be expected to be absorbed or cause any adverse effects in breastfed infants. No special precautions are required.


Drug Levels:


Maternal Levels.

A single milk level of 12.7 mg/L was found 4 hours after the end of the infusion of vancomycin 1 gram intravenously given every 12 hours in one woman. Her peak and trough serum levels were 36.1 and 12.5 mg/L, respectively. The milk was obtained during the third trimester of pregnancy at a gestational age of about 35 to 38 weeks.[1] Using the serum level reported, an exclusively breastfed infant would receive 1.9 mg/kg daily by mouth in breastmilk. This dose is only about 4.8% of the oral vancomycin dose of 40 mg/kg daily used to treat pseudomembranous colitis in infants.

Infant Levels.

Relevant published information was not found as of the revision date.


Effects in Breastfed Infants:


Relevant published information was not found as of the revision date.


Possible Effects on Lactation:


Relevant published information was not found as of the revision date.


Alternate Drugs to Consider:


Daptomycin


References:


1. Reyes MP, Ostrea Jr. EM, Cabinian AE et al. Vancomycin during pregnancy: does it cause hearing loss or nephrotoxicity in the infant? Am J Obstet Gynecol. 1989;161:977-81. PMID:2801848



Substance Identification:




Substance Name:

Vancomycin

CAS Registry Number:

1404-90-6

Drug Class:


  • Antiinfective Agents

  • Antibacterial Agents

  • Glycopeptides


  • Administrative Information:




    LactMed Record Number:


    394


    Last Revision Date:


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