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249 lines
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<meta name="description" content="Substantial information indicates that ampicillin produces low levels in milk that are not expected to cause adverse effects in breastfed infants. Occasionally disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush have been reported with penicillins, but these effects have not been adequately evaluated. Ampicillin is acceptable in nursing mothers.">
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<meta name="og:description" content="Substantial information indicates that ampicillin produces low levels in milk that are not expected to cause adverse effects in breastfed infants. Occasionally disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush have been reported with penicillins, but these effects have not been adequately evaluated. Ampicillin is acceptable in nursing mothers.">
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class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK500994_"><span class="title" itemprop="name">Ampicillin</span></h1><p class="fm-aai"><a href="#_NBK500994_pubdet_">Publication Details</a></p><p><em>Estimated reading time: 3 minutes</em></p></div></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><p>CASRN: 69-53-4</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/134971670" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=134971670" alt="image 134971670 in the ncbi pubchem database" /></a><div id="LM15.Drug_Levels_and_Effects"><h2 id="_LM15_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM15.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Substantial information indicates that ampicillin produces low levels in milk that are not expected to cause adverse effects in breastfed infants. Occasionally disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush have been reported with penicillins, but these effects have not been adequately evaluated. Ampicillin is acceptable in nursing mothers.</p></div><div id="LM15.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> After an ampicillin oral dose of 500 mg every 6 hours for 3 days, milk levels fluctuated little and ranged from 0.575 to 1 mg/L (mean 0.8 mg/L) at various times in one mother and 0.014 mg/L to 0.0675 mg/L (average 0.03 mg/L) in another.[<a class="bibr" href="#LM15.REF.1" rid="LM15.REF.1">1</a>]</p><p>In 10 mothers given ampicillin 1.5 or 2 grams daily by mouth for 3 doses had milk levels ranging from 0.03 to 0.2 mg/L. Another mother receiving 3 grams daily by mouth had milk levels of 0.08 to 0.3 mg/L. In 3 mothers who received 2 grams daily intramuscularly, milk levels ranged from 0.3 to 0.9 mg/L and in 3 mothers who received 4 grams daily intramuscularly had milk levels of 0.4 to 0.9 mg/L. In all cases, peak milk levels occurred 3 hours after the dose. The breastfed infant was estimated to receive from 0.08 to 0.2 mg daily of ampicillin with these doses.[<a class="bibr" href="#LM15.REF.2" rid="LM15.REF.2">2</a>]</p><p>A study in postpartum women with endometritis who received ampicillin 1 or 2 grams infused intravenously over 20 minutes found the average milk levels of ampicillin to be 1.7 mg/L with the highest level observed 3 mg/L.[<a class="bibr" href="#LM15.REF.3" rid="LM15.REF.3">3</a>]</p><p>In 15 women receiving ampicillin 500 mg 4 times daily by intramuscular injection, average milk ampicillin levels were as follows: 0.11 mg/L at 30 minutes after the injection; 0.21 mg/L at 1 hour, 0.17 at 2 hours, 0.27 mg/L at 4 hours and 0.26 mg/L at 6 hours after the injection.[<a class="bibr" href="#LM15.REF.4" rid="LM15.REF.4">4</a>]</p><p>In 13 women with mastitis who received 1 gram of ampicillin orally 4 times daily, the average milk concentrations ranged from 0.6 to 1.05 mg/L.[<a class="bibr" href="#LM15.REF.5" rid="LM15.REF.5">5</a>]</p><p>In 15 women given a single 2 grams dose of ampicillin intravenously, milk levels averaged 1.1 mg/L 2 hours after the dose.[<a class="bibr" href="#LM15.REF.6" rid="LM15.REF.6">6</a>]</p><p><i>Infant Levels.</i> Thirteen women with mastitis received 1 gram of ampicillin orally 4 times daily. Ampicillin was detectable in the urine in only 2 of 8 of the breastfed infants in whom it was measured.[<a class="bibr" href="#LM15.REF.5" rid="LM15.REF.5">5</a>]</p></div><div id="LM15.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>An uncontrolled observation of the breastfed infants of mothers taking ampicillin noted a seeming increase in cases of diarrhea and candidiasis that was attributed to ampicillin in breastmilk.[<a class="bibr" href="#LM15.REF.7" rid="LM15.REF.7">7</a>]</p><p>In a prospective follow-up study, 5 nursing mothers reported taking ampicillin (dosage unspecified). One mother reported diarrhea in her infant. No rashes or candidiasis were reported among the exposed infants.[<a class="bibr" href="#LM15.REF.8" rid="LM15.REF.8">8</a>]</p><p>A small, controlled, prospective study had mothers monitor their infants for signs of adverse effects (furring of the tongue, feeding difficulties, changes in stool frequency and consistency, diaper rash, and skin rash). Weight change and the development of jaundice were also recorded. No statistical differences in these parameters were found between the infants of the control mothers and those of mothers taking ampicillin.[<a class="bibr" href="#LM15.REF.9" rid="LM15.REF.9">9</a>]</p></div><div id="LM15.Effects_on_Lactation_and_Breastmilk"><h3>Effects on Lactation and Breastmilk</h3><p>Relevant published information was not found as of the revision date.</p></div><div id="LM15.References"><h3>References</h3><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="LM15.REF.1">Lohmeyer
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H, Halfpap
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E.
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[Pharmacokinetic studies and clinical experiences with ampicillin during treatment of infections of the urogenital tract of the female]. Z Geburtshilfe Gynakol
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1965;164:184-202.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/5887161" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 5887161</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="LM15.REF.2">Pons G, Rey E. Antibiotics excretion in breast milk. Med Mal Infect 1994;24 (Special Issue 1):1088-106.</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="LM15.REF.3">Foulds G, Miller RD, Stankewich JP, et al. The pharmacokinetics of subactam and ampicillin in postpartum women. In, Spitzy KH, Karrer K, eds. Proc 13th Int Congress Chemother 1983;1:23/17-23/22.</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="LM15.REF.4">Amiraslanova
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LA, Emel'yanova
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AI, Fursova
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SA, et al.
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Some aspects of ampicillin, kanamycin and cefuroxim pharmacokinetics in puerperant patients with endometritis.
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Akush Ginekol (Mosk)
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1985;10
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14-7.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/2934996" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2934996</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>5.</dt><dd><div class="bk_ref" id="LM15.REF.5">Peiker
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G, Schroder
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S. The concentration of oxacillin and ampicillin (Penstabil) in mother's milk in puerperal mastitis.
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Pharmazie
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1986;41:793-5.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/3562514" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3562514</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>6.</dt><dd><div class="bk_ref" id="LM15.REF.6">Zhang
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Y, Zhang
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Q, Xu
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Z. Tissue and body fluid distribution of antibacterial agents in pregnant and lactating women.
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Zhonghua Fu Chan Ke Za Zhi
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1997;32:288-92.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/9596854" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9596854</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>7.</dt><dd><div class="bk_ref" id="LM15.REF.7">Williams
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M.
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Excretion of drugs in milk.
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Pharm J
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1976;217:219.</div></dd></dl><dl class="bkr_refwrap"><dt>8.</dt><dd><div class="bk_ref" id="LM15.REF.8">Ito
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S, Blajchman
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A, Stephenson
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M, et al.
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Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication.
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Am J Obstet Gynecol
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1993;168:1393-9.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/8498418" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8498418</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>9.</dt><dd><div class="bk_ref" id="LM15.REF.9">Campbell
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AC, McElnay
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JC, Passmore
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CM. The excretion of ampicillin in breast milk and its effect on the suckling infant.
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Br J Clin Pharmacol
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1991;31:230p. doi:10.1111/j.1365-2125.1991.tb05523.x [<a href="http://dx.crossref.org/10.1111/j.1365-2125.1991.tb05523.x" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl></dl></div></div><div id="LM15.Substance_Identification"><h2 id="_LM15_Substance_Identification_">Substance Identification</h2><div id="LM15.Substance_Name"><h3>Substance Name</h3><p>Ampicillin</p></div><div id="LM15.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>69-53-4</p></div><div id="LM15.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Anti-Infective Agents</p><p>Antibacterial Agents</p><p>Penicillins</p></div></div><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></dl></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK500994_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Revision: <span itemprop="dateModified">January 15, 2025</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div></div><h3>Publisher</h3><p><a href="https://www.nlm.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Child Health and Human Development</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Ampicillin. [Updated 2025 Jan 15].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/lactmed/LM446/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/lactmed/LM14/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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