Pregnancy is always a special situation where every action or side effect of the drug varies when compared to a situation of a non-pregnant patient. It is not only because the pregnant woman's metabolism differs due to the hormonal and other changes happened to her, but also because every medicine or its metabolite passes to the baby and shows its action there. The only thing is, be cautious, attentive and well supervised when you take any single drug in pregnancy. The interactions can vary in pregnancy, and the dosage may differ as well. Strict supervision of the Physician is mandatory.
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Gentamicin crosses the placenta.
[US Boxed Warning]: Aminoglycosides may cause fetal harm if administered to a pregnant woman. There are several reports of total irreversible bilateral congenital deafness in children whose mothers received another aminoglycoside (streptomycin) during pregnancy. Although serious side effects to the fetus/infant have not been reported following maternal use of all aminoglycosides, a potential for harm exists.
Due to pregnancy-induced physiologic changes, some pharmacokinetic parameters of Gentamicin may be altered (Popović 2007). Gentamicin use has been evaluated for various infections in pregnant women including the treatment of acute pyelonephritis (Jolley 2010) and as an alternative antibiotic for prophylactic use prior to cesarean delivery (Bratzler 2013).
Gentamicin breastfeeding
When a drug is taken when the patient is breast feeding, a part of the drug is secreted in her breast milk and is passed to the baby. The dosage of the medicine to mother and baby are different, and many drugs actions are side effects when you take them without a disease, and what if you the baby takes them without a disease? What if the drug is contraindicated in newborns, infants or children? So, breastfeeding is a very alarming situation when the mother is on medications. Ask your Physician or Pediatrician about the effect of the drug on the baby and how much is excreted in breast milk and if it harms the baby!
Gentamicin is excreted into breast milk in small amounts. At 1 and 7 hours following a dose of Gentamicin, serum concentrations averaged 3.9 and 1.1 mcg/mL, respectively, while milk concentrations averaged 0.4 and 0.4 mcg/mL. The milk:plasma ratio averaged 0.11 and 0.44, respectively. Infants were fed one hour after administration of Gentamicin. Gentamicin was detected in the serum of 5 of 10 infants with an average serum concentration of 0.4 mcg/mL. The five other infants had undetectable levels (below 0.27 mcg/mL). Gentamicin is considered compatible with breast-feeding by the American Academy of Pediatrics.
Weinstein AJ, Gibbs RS, Gallagher M "Placental transfer of clindamycin and Gentamicin in term pregnancy." Am J Obstet Gynecol 124 (1976): 688-91
Briggs GG, Freeman RK, Yaffe SJ.. "Drugs in Pregnancy and Lactation. 5th ed." Baltimore, MD: Williams & Wilkins (1998):
References for breastfeeding information
"American Academy of Pediatrics. Committee on Drugs. The transfer of drugs and other chemicals into human milk." Pediatrics 108 (2001): 776-89
Celiloglu M, Celiker S, Guven H, Tuncok Y, Demir N, Erten O "Gentamicin excretion and uptake from breast milk by nursing infants." Obstet Gynecol 84 (1994): 263-5
DailyMed. "GENTAMICIN SULFATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
PubMed Health. "Ocu-Mycin: This section provide the link out information of drugs collectetd in PubMed Health. ". http://www.ncbi.nlm.nih.gov/pubmedhe... (accessed September 17, 2018).
Human Metabolome Database (HMDB). "Gentamicin: The Human Metabolome Database (HMDB) is a freely available electronic database containing detailed information about small molecule metabolites found in the human body.". http://www.hmdb.ca/metabolites/HMDB0... (accessed September 17, 2018).
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