brand logo

Am Fam Physician. 1998;58(6):1306

to the editor: I enjoyed the excellent article on conjunctivitis written by Drs. Morrow and Abbott.1 I found it to be practical and useful. I do feel, however, that one point in the article is in error.

They write that systemic tetracyclines are contraindicated in women who are nursing. Tetracycline is excreted into breast milk in low concentrations. It binds to calcium in breast milk and is absorbed poorly by the infant. A study of lactating women who were taking 500 mg of tetracycline four times a day found that levels of tetracycline in the infants were below the level of detection (0.05 μg per mL).2,3 Theoretic concerns about the possibility of dental staining or delayed bone growth in the infants seems unlikely at these serum concentrations.3

In their publication “Transfer of Drugs and Other Chemicals into Human Milk,” the American Academy of Pediatrics places tetracycline under the label “Usually Compatible with Breast-Feeding,” the classification used for those medications that are safest in lactation.4

Better choices may be available for the treatment of meibomianitis or acne rosacea in lactating women, especially since these conditions often require prolonged treatment, but I feel it is unwise to perpetuate the misconception that tetracyclines are always contraindicated during lactation.

editor's note: This letter was sent to the authors of “Conjunctivitis,” who declined to reply.

Email letter submissions to Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors. Letters submitted for publication in AFP must not be submitted to any other publication. Letters may be edited to meet style and space requirements.

This series is coordinated by Kenny Lin, MD, MPH, deputy editor.

Continue Reading

More in AFP

More in PubMed

Copyright © 1998 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.