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Levofloxacin and Prednisone for Pneumonia, conflicting instructions

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  • Levofloxacin and Prednisone for Pneumonia, conflicting instructions


    I have a 14 week old breastfed infant who we have been supplementing with formula to help with weight gain. I was diagnosed with pneumonia and told to pump and dump while I take a 7 day course of 500mg of levofloxacin and a 5 day course of 20mg of prednisone, along with inhaled Albuterol every 6 hours. Two internal medicine doctors have told me absolutely no breastfeeding, but two lactation consultants and my ob/gyn office have said it is "probably safe". I've looked through the forums and research that I can find and have found information pertaining to toddlers, who get less breastmilk relative to body weight, but I am not sure how age impacts the decision to continue to breastfeed.

    Could you provide some information or advice as far as whether it would be safe to continue to breastfeed my son, and if so, how I should pace it? For example, if I take the medicines right after his morning feed (I am susceptible to the restlessness/insomnia side effects if I take them later in the day), how long would you recommend waiting before resuming breastfeeding?

    Thank you in advance for any guidance!

  • #2

    Levaquin (levofloxacin) is rated an L2-limited data-probably compatible. The amount transferred into breast milk is 10.5-17.2% of your dose.[COLOR=#333333][FONT=lucida grande] Levofloxacin concentrations in milk peak around 1-1.8 hours and at levels close to maternal plasma levels. We recommend waiting a minimum of 2 hours to breastfeed after a dose. The half-life is 6-8 hours. Monitor the infant for vomiting, diarrhea, rash and thrush, as long as the infant is not symptomatic it should be ok.

    Prednisone is rated an L2-limited data-probably compatible. The amount transferred is 1.8-5.3% of your dose. Low dose short term therapy is probably ok. We get concerned with high doses (>40 mg/day), particularly for long periods, (greater than 3-4 weeks) because steroids could potentially produce problems in infant growth and development. We recommend taking it right after you breastfeed so you have a longer break period before feeding again, half-life is 2-3 hours.

    Albuterol is rated an L1-no data-compatible. We do not know how much transfers into breast milk. take right after breastfeeding, peak time is 5-30 minutes and half-life is 3.8 hours. Monitor for irritability, insomnia, arrhythmias, weight loss, tremor.

    I hope this helps.

    Sandra Lovato R.N.
    InfantRisk Center


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