Drugs in Pregnancy and Lactation: Tenth Edition

POLYMYXIN B

Antibiotic

PREGNANCY RECOMMENDATION: Compatible (Topical)

BREASTFEEDING RECOMMENDATION: Compatible (Topical)

PREGNANCY SUMMARY

No reports linking the use of polymyxin B with congenital defects have been located. Although available for injection, polymyxin B is used almost exclusively by topical administration.

FETAL RISK SUMMARY

In one study, seven polymyxin B exposures were recorded in the 1st trimester (1). No association with congenital defects was observed. In a brief 2005 report from the Hungarian Case–Control Surveillance of Congenital Abnormalities (1980–1996) database, 6 infants, among 22,843 cases (fetus or newborn) with birth defects, were exposed in utero to parenteral polymyxin B (2). Two of the cases, exposed in the 1st trimester (one in the 1st and the other in the 3rd month of gestation), had cardiovascular malformations. The other four cases, neural tube defect, microcephaly, limb reduction defect, and talipes equinovarus, were exposed after the 1st trimester. There were 13 exposed infants in the matched controls. The crude odds ratio for 1st trimester exposure was 0.8, 95% confidence interval 0.3–2.0 (2).

BREASTFEEDING SUMMARY

No reports describing the use of polymyxin B during human lactation have been reported.

References

1.Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA: Publishing Sciences Group, 1977:297.

2.Kazy Z, Puho E, Czeizel AE. Parenteral polymyxin B treatment during pregnancy. Reprod Toxicol 2005;20:181–2.