Is (S)-Ofloxacin Safe in Breastfeeding

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

Is the S-isomer of ofloxacin. Recently, quinolone-related medication has been used in neonates and infants without apparent side effects. It trespasses in tiny amounts into breast milk. Absorption through the child’s gut may be interfered by the calcium contained in the milk. Should it be necessary to prescribe it to a nursing mother, Norfloxacine, Ofloxacine and Ciprofloxacine have shown a lower level in the milk and thus must be the preferred drugs. Because a case of pseudomembranose colitis has been described possibly related to mother ingestion of Ciporfloxacine in a premature infant previously affected of NEC, a close follow-up for diarrhea is warranted. Be aware of the possibility of false negative results of bacterial cultures when the mother is on antibiotics.

(S)-Ofloxacin is the -enantiomer of the fluoroquinolone, ofloxacin. No information is available on the clinical use of (S)-Ofloxacin during breastfeeding. However, amounts in breastmilk appear to be low and would not be expected to cause any adverse effects in breastfed infants. Fluoroquinolones such as (S)-Ofloxacin have traditionally not been used in infants because of concern about adverse effects on the infants' developing joints. However, recent studies indicate little risk.[1][2] The calcium in milk might prevent absorption of the small amounts of fluoroquinolones in milk,[3] but insufficient data exist to prove or disprove this assertion. Use of (S)-Ofloxacin 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 4 to 6 hours after a dose should decrease the exposure of the infant to (S)-Ofloxacin in breastmilk. Maternal use of an eye drop that contains (S)-Ofloxacin presents negligible risk for the nursing infant.