Document Detail


Randomised controlled study of oral erythromycin for treatment of gastrointestinal dysmotility in preterm infants.
MedLine Citation:
PMID:  11320044     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To evaluate the effectiveness of oral erythromycin as a prokinetic agent for the treatment of moderately severe gastrointestinal dysmotility in preterm very low birthweight infants. METHODS: A prospective, double blind, randomised, placebo controlled study in a tertiary referral centre of a university teaching hospital was conducted on 56 preterm infants (< 1500 g) consecutively admitted to the neonatal unit. The infants were randomly allocated by minimisation to receive oral erythromycin (12.5 mg/kg, every six hours for 14 days) or an equivalent volume of placebo solution (normal saline) if they received less than half the total daily fluid intake or less than 75 ml/kg/day of milk feeds by the enteral route on day 14 of life. The times taken to establish half, three quarters, and full enteral feeding after the drug treatment were compared between the two groups. Potential adverse effects of oral erythromycin and complications associated with parenteral nutrition were assessed as secondary outcomes. RESULTS: Twenty seven and 29 infants received oral erythromycin and placebo solution respectively. The times taken to establish half, three quarters, and full enteral feeding after the drug treatment were significantly shorter in the group receiving oral erythromycin than in those receiving the placebo (p < 0.05, p < 0.05 and p < 0.0001 respectively). There was also a trend suggesting that more infants with prolonged feed intolerance developed cholestatic jaundice in the placebo than in the oral erythromycin group (10 v 5 infants). None of the infants receiving oral erythromycin developed cardiac dysrhythmia, pyloric stenosis, or septicaemia caused by multiresistant organisms. CONCLUSIONS: Oral erythromycin is effective in facilitating enteral feeding in preterm very low birthweight infants with moderately severe gastrointestinal dysmotility. Treated infants can achieve full enteral feeding 10 days earlier, and this may result in a substantial saving on hyperalimentation. However, until the safety of erythromycin has been confirmed in preterm infants, this treatment modality should remain experimental. Prophylactic or routine use of this medication for treatment of mild cases of gastrointestinal dysmotility is probably not warranted at this stage.
Authors:
P C Ng; K W So; K S Fung; C H Lee; T F Fok; E Wong; W Wong; K L Cheung; A F Cheng
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  84     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-04-26     Completed Date:  2001-05-24     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F177-82     Citation Subset:  AIM; IM    
Affiliation:
Department of Paediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, NT. pakcheungng@cuhk.edu.hk
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MeSH Terms
Descriptor/Qualifier:
Double-Blind Method
Enteral Nutrition
Erythromycin / therapeutic use*
Female
Gastrointestinal Agents / therapeutic use*
Gastrointestinal Diseases / drug therapy*
Gastrointestinal Motility / drug effects
Humans
Infant, Newborn
Infant, Premature*
Infant, Very Low Birth Weight*
Male
Statistics, Nonparametric
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Gastrointestinal Agents; 114-07-8/Erythromycin
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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