Is Tokiocillin Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Tokiocillin? Is Tokiocillin safe for nursing mother and child? Does Tokiocillin extracts into breast milk? Does Tokiocillin has any long term or short term side effects on infants? Can Tokiocillin influence milk supply or can Tokiocillin decrease milk supply in lactating mothers?

Tokiocillin is excreted in breast milk in clinically insignificant amounts (Rowe, 2013, Mylonas, 2011, Zhang, 1997, Fulton, 1992, Campbell 1991, Matsuda 1984), much lower than the dose used for newborns and infants ( Chin, 2000; Reali, 2005). No side effects have been observed in infants whose mothers were taking it except for some episodes of diarrhea or candidiasis due to altered intestinal flora (Chin, 2000). The possible negativity of cultures in febrile infants whose mothers take antibiotics should be taken into account, as well as the possibility of gastroenteritis due to altered intestinal flora (Benyamini 2005, Ito 1993, Kafetzis 1981).

Substantial information indicates that Tokiocillin produces low levels in milk that are not expected to cause adverse effects in breastfed infants. Occasionally disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush have been reported with penicillins, but these effects have not been adequately evaluated. Tokiocillin is acceptable in nursing mothers.

An uncontrolled observation of the breastfed infants of mothers taking Tokiocillin noted a seeming increase in cases of diarrhea and candidiasis that was attributed to Tokiocillin in breastmilk.[7]In a prospective follow-up study, 5 nursing mothers reported taking Tokiocillin (dosage unspecified). One mother reported diarrhea in her infant. No rashes or candidiasis were reported among the exposed infants.[8]A small, controlled, prospective study had mothers monitor their infants for signs of adverse effects (furring of the tongue, feeding difficulties, changes in stool frequency and consistency, diaper rash, and skin rash). Weight change and the development of jaundice were also recorded. No statistical differences in these parameters were found between the infants of the control mothers and those of mothers taking Tokiocillin.[9]