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Ofloxacin eye drops

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  • Ofloxacin eye drops

    I'm currently working with a client who is exclusively breastfeeding her 16w old baby. The mother has developed an eye infection and has been prescribed ofloxacin eye drops 6 times/day. She has been told to stop breastfeeding for 7 days while she is treated. Could you please advise on the safety of this drug given the method of administration?

    Thanks

  • #2
    Hi, thanks for your post.

    The evidence we have indicates that, WHEN TAKEN ORALLY, infants get about 3% of the mother's dose of ofloxacin. As with all antibiotics, the principle side effects would be diarrhea, vomiting, or very unlikely, Clostridium difficile infection. The chances of developing these side effects are low given the small amount of medication that makes it to the infant. Rarely, individuals have a particular sensitivity to ofloxacin, such as allergy, arrhythmia, or a seizure disorder. Accounting for all that, we give ORAL ofloxacin an L2 rating (out of 5) ("Safer") with regards to its lactation safety. It is one of the better choices in the fluoroquinolone drug class for breastfeeding mothers.

    Regarding the eye drops, here is a direct quote from the pharmaceutical manufacturer's prescribing information (emphasis mine):

    Serum, urine and tear concentrations of ofloxacin were measured in 30 healthy women at various time points during a ten-day course of treatment with ofloxacin ophthalmic solution. The mean serum ofloxacin concentration ranged from 0.4 ng/mL to 1.9 ng/mL. Maximum ofloxacin concentration increased from 1.1 ng/mL on day one to 1.9 ng/mL on day 11 after QID dosing for 10 1/2 days. Maximum serum ofloxacin concentrations after ten days of topical ophthalmic dosing were more than 1000 times lower than those reported after standard oral doses of ofloxacin.

    Please call us at the InfantRisk Center if this has not completely answered your question. (806)352-2519

    -James Abbey, MD

    The following reference may be useful to your physician if he or she needs more information:

    Giamarellou H, Kolokythas E, Petrikkos G, Gazis J, Aravantinos D, Sfikakis P. Pharmacokinetics of three newer quinolones in pregnant and lactating women. Am J Med 1989; 87(5A):49S-51S.

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