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Influence of erythromycin on establishment of feeding in preterm infants: observations from a randomised controlled
B J Stenson1, L Middlemist, A J Lyon
1Neonatal Unit, Simpson Memorial Maternity Pavilion, Edinburgh. Stensonb@telemedicine.clh.ed.ac.uk
Insights
Erythromycin did not significantly improve enteral feeding establishment in very preterm infants. This study found no benefit in using erythromycin for feeding tolerance or necrotizing enterocolitis in ventilated neonates.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Pharmacology
Background:
- Enteral feeding is crucial for preterm infant growth.
- Establishing enteral feeding can be challenging in ventilated neonates.
- Antimicrobial use in neonates requires careful consideration of benefits and risks.
Purpose of the Study:
- To evaluate the efficacy of erythromycin in facilitating enteral feeding establishment.
- To assess the impact of erythromycin on feeding tolerance and gastrointestinal outcomes in preterm infants.
Main Methods:
- A randomized controlled trial involving 76 infants (< 31 weeks gestation).
- Infants received either erythromycin or a placebo for the first 7 days of life.
- Outcomes included feed toleration, time to full enteral feeding, vomiting, and necrotizing enterocolitis.
Main Results:
- No significant differences were observed between the erythromycin and control groups for any measured outcome.
- Median age for achieving full enteral feeding was 8 days in the erythromycin group versus 9 days in the control group.
- Erythromycin did not impact feed toleration or the incidence of necrotizing enterocolitis.
Conclusions:
- Antimicrobial doses of intravenous erythromycin do not appear to benefit the introduction of feeding in preterm infants.
- Further research may be needed to explore alternative strategies for optimizing enteral feeding in this population.
- The findings suggest erythromycin is unlikely to be a beneficial adjunct for feeding establishment in very preterm neonates.
Aim:
To determine the effect of erythromycin on the establishment of enteral feeding in ventilated infants < 31 weeks gestation.
Methods:
Erythromycin was randomly allocated as an antimicrobial treatment for the first 7 days of life in 76 infants: 35 received erythromycin and 41 acted as controls. Feed toleration, time taken to establish full enteral feeding, vomiting, prescription of glycerine suppositories and occurrence of necrotising enterocolitis were recorded.
Results:
There were no significant differences between the groups for any of the outcomes. The infants treated with erythromycin reached full feeding at a median (quartile) age of 8 (5-12) days compared with 9 (6-14) days for controls.
Conclusions:
Intravenous erythromycin in antimicrobial doses is unlikely to benefit the introduction of feeding in preterm infants.