Long Term Amoxicillian Usage

[KHenryBFPC]

I have a pregnant client who has selective IGA autoimmune disease and states that she is currently taking 500 mg of amoxicillin per day, every day as part of a long term treatment. She has been ok'd to use this during pregnancy, but neither myself or her doctor have any experience with this for breastfeeding. I know that amoxicillin is typically considered safe for breastfeeding and often used in neonates and children. What we're wondering is if there are any concerns of using it long term while breastfeeding.

Thank you for any information you may have.

[admin-james]

Hi, thanks for your post.

There were multiple studies in the 90's looking at the possibility of using long-term amoxicillin as chemoprophylaxis for recurrent otitis media. The studies put children on amoxicillin daily for 3-6 months. The authors do not discuss side-effects, but conclude that long-term amoxicillin is a valid therapeutic option. In our experience, long-term, sub-therapeutic exposure to amoxicillin will not cause any problems beyond mild GI upset. I have included a citation for a recent systematic review of the otitis media studies. I understand that this is not what your mom is being treated for, but it is documentation of long-term exposure to amoxicillin in children.

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

James Abbey, MD

Cheong KH, Hussain SS. Management of recurrent acute otitis media in children:
systematic review of the effect of different interventions on otitis media
recurrence, recurrence frequency and total recurrence time. J Laryngol Otol. 2012
Sep;126(9):874-85.