Wada Yuka Sano, Saito Jumpei, Hashii Yuko, Kishi Tomomi, Kobayashi Masayuki, Kamiya Taro, Mizuno Katsumi
Division of Neonatology, Center for Maternal-Fetal, Neonatal, and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
Department of Pharmaceuticals, National Center for Child Health and Development, Tokyo, Japan.
J Hum Lact. 2022 May;38(2):248-251. doi: 10.1177/08903344221076539. Epub 2022 Feb 21.
Remdesivir was originally developed to treat Ebola hemorrhagic fever, and its efficacy in treating coronavirus disease 2019 was detected during a preliminary analysis of a randomized controlled trial. It is known that Severe Acute Respiratory Syndrome Coronavirus 2 is not transmitted through human milk, but data about the presence of remdesivir in human milk have been lacking.
In this case study, we determined the human milk-to-serum drug concentration ratio and the relative dose of Remdesivir in one participant.
The participant, a 28-year-old primipara, was found to have Coronavirus 2 infection in 2019, 2 days after delivery. She was given Remdesivir. The Remdesivir concentration in maternal serum and human milk was measured, and the milk-to-serum drug concentration ratio was found to be low (0.089), as was the relative infant dose (0.0070). The participant could not breastfeed her infant during her Coronavirus 2 infection treatment because in Japan anyone with COVID-19 was completely quarantined. However, she was able to resume breastfeeding after discharge and breastfed her infant for 6 months with supplements.
Given the low amount of Remdesivir in the participant's milk, the inclusion of antibodies to Severe Acute Respiratory Syndrome Coronavirus 2, which can be expected to protect the infant from infection, and various other benefits of human milk, suggests that breastfeeding is safe during treatment with Remdesivir.
瑞德西韦最初是为治疗埃博拉出血热而研发的，其在治疗2019冠状病毒病中的疗效在一项随机对照试验的初步分析中被检测到。已知严重急性呼吸综合征冠状病毒2不会通过母乳传播，但关于母乳中瑞德西韦存在情况的数据一直缺乏。
在本病例研究中，我们确定了一名参与者母乳与血清中的药物浓度比以及瑞德西韦的相对剂量。
该参与者为一名28岁初产妇，在分娩后2天被发现感染了2019冠状病毒。她接受了瑞德西韦治疗。测量了母体血清和母乳中的瑞德西韦浓度，发现母乳与血清的药物浓度比很低（0.089），相对婴儿剂量也很低（0.0070）。在该参与者接受2019冠状病毒感染治疗期间，她无法母乳喂养婴儿，因为在日本，任何新冠肺炎患者都被完全隔离。然而，她出院后能够恢复母乳喂养，并辅以补充剂，母乳喂养婴儿6个月。
鉴于该参与者母乳中瑞德西韦含量较低，且母乳中含有可预期保护婴儿免受感染的严重急性呼吸综合征冠状病毒2抗体以及母乳的各种其他益处，这表明在使用瑞德西韦治疗期间母乳喂养是安全的。
