毒理性
哺乳期使用总结：母乳中环丙沙星的量是低的。由于对婴儿发育中的关节可能产生不良反应的担忧，传统上不使用环丙沙星等氟喹诺酮类药物。然而，研究显示风险很小。母乳中的钙可能会减少对少量氟喹诺酮类药物的吸收，但现有数据不足以证明或反驳这一说法。在监测婴儿可能的胃肠道菌群影响（如腹泻或念珠菌病（鹅口疮，尿布疹））的情况下，哺乳期母亲可以使用环丙沙星。在服用剂量后的3到4小时内避免哺乳可以减少婴儿通过母乳接触到环丙沙星的风险。
母亲使用含有环丙沙星的滴耳液或滴眼液对哺乳婴儿的风险微乎其微。为了显著减少使用眼药水后到达母乳的药物量，可以在眼角处按压泪管1分钟或更长时间，然后用吸收性纸巾去除多余的溶液。
◉ 对哺乳婴儿的影响：一名有坏死性小肠结肠炎病史的2个月大哺乳婴儿的假膜性结肠炎案例，可能是母亲自行使用环丙沙星治疗引起的。
环丙沙星作为多药方案的组成部分，用于治疗三名孕期和产后对多种药物有抗药性的结核病妇女。他们的三名婴儿被哺乳（哺乳的程度和持续时间未说明）。在1.25岁、1.8岁和3.9岁时，孩子们除了一个因出生后感染结核病而发育不良外，其他都发育正常。
◉ 对哺乳和母乳的影响：截至修订日期，未找到相关的已发布信息。
◉ Summary of Use during Lactation:Amounts of ciprofloxacin in breastmilk are low. Fluoroquinolones such as ciprofloxacin have traditionally not been used in infants because of concern about adverse effects on the infants' developing joints. However, studies indicate little risk. The calcium in milk might decrease absorption of the small amounts of fluoroquinolones in milk, but insufficient data exist to prove or disprove this assertion. Use of ciprofloxacin is acceptable in nursing mothers with monitoring of the infant for possible effects on the gastrointestinal flora, such as diarrhea or candidiasis (thrush, diaper rash). Avoiding breastfeeding for 3 to 4 hours after a dose should decrease the exposure of the infant to ciprofloxacin in breastmilk.
Maternal use of an ear drop or eye drop that contains ciprofloxacin presents negligible risk for the nursing infant. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.
◉ Effects in Breastfed Infants:A case of pseudomembranous colitis in a 2-month-old breastfed infant with a history of necrotizing enterocolitis was probably caused by maternal self-treatment with ciprofloxacin.
Ciprofloxacin was used as part of multi-drug regimens to treat three pregnant women with multidrug-resistant tuberculosis throughout pregnancy and postpartum. Their three infants were breastfed (extent and duration not stated). At age 1.25, 1.8 and 3.9 years, the children were developing normally except for one who had failure to thrive, possibly due to tuberculosis contracted after birth.
◉ Effects on Lactation and Breastmilk:Relevant published information was not found as of the revision date.
来源:Drugs and Lactation Database (LactMed)
