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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Sumamecin crosses the placenta (Ramsey 2003).
The maternal serum half-life of Sumamecin is unchanged in early pregnancy and decreased at term; however, high concentrations of Sumamecin are sustained in the myometrium and adipose tissue (Fischer 2012; Ramsey 2003).
Sumamecin may be used as an alternative or adjunctive prophylactic antibiotic in females undergoing unplanned cesarean delivery (ACOG 199 2018). Sumamecin is recommended for the treatment of several infections, including chlamydia, gonococcal infections, and Mycobacterium avium complex in pregnant patients (consult current guidelines) (CDC [Workowski 2015]; HHS [OI adult] 2019). Sumamecin may also be used in certain situations prior to vaginal delivery in females at high risk for endocarditis (ACOG 199 2018).
Sumamecin 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!
Sumamecin is excreted into human milk. The manufacturer recommends that caution be used when administering Sumamecin to nursing women.
In one lactating woman receiving Sumamecin 500 mg/day, Sumamecin milk concentration measured 1.3 and 2.8 mcg/mL 1 hour after the first dose and 30 hours after the third dose, respectively.
See references
References for pregnancy information
Wehbeh HA, Ruggeirio RM, Shahem S, Lopez G, Ali Y "Single-dose Sumamecin for Chlamydia in pregnant women." J Reprod Med 43 (1998): 509-14
Bush MR, Rosa C "Sumamecin and erythromycin in the treatment of cervical chlamydial infection during pregnancy." Obstet Gynecol 84 (1994): 61-3
Adair CD, Gunter M, Stovall TG, McElroy G, Veille JC, Ernest JM "Chlamydia in pregnancy: a randomized trial of Sumamecin and erythromycin." Obstet Gynecol 91 (1998): 165-8
Donders GGG "Treatment of sexually transmitted bacterial diseases in pregnant women." Drugs 59 (2000): 477-85
"Product Information. Zithromax (Sumamecin)." Pfizer US Pharmaceuticals, New York, NY.
References for breastfeeding information
"Product Information. Zithromax (Sumamecin)." Pfizer US Pharmaceuticals, New York, NY.
Kelsey JJ, Moser LR, Jennings JC, Munger MA "Presence of Sumamecin breast milk concentrations: a case report." Am J Obstet Gynecol 170 (1994): 1375-6
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References
DailyMed. "AZITHROMYCIN: 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. "Zithromax: 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). "Azithromycin: 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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