Related Experiment Videos
Can prophylactic oral erythromycin reduce time to full enteral feeds in preterm neonates?
S K Patole1, R Almonte, R Kadalraja
1Department of Neonatology, Kirwan Hospital for Women, Queensland, Australia.
Insights
Oral erythromycin did not significantly speed up establishing full enteral feeds in preterm neonates. This study found no difference in feeding times between neonates receiving erythromycin or a placebo.
Area of Science:
- Neonatal Medicine
- Pharmacology
- Gastroenterology
Background:
- Premature neonates (< 32 weeks) often face challenges establishing full enteral feeds.
- Prophylactic antibiotics are sometimes considered to improve feeding tolerance and outcomes.
- Erythromycin is a macrolide antibiotic with potential gastrointestinal effects.
Purpose of the Study:
- To evaluate the efficacy of oral erythromycin in reducing the time to establish full enteral feeds in preterm neonates.
- To assess the safety and side-effects of prophylactic erythromycin in this population.
Main Methods:
- A double-blind, randomized trial involving 73 neonates (< 32 weeks gestational age) was conducted.
- Participants received either oral erythromycin ethyl succinate or a placebo until full enteral feeds were achieved or for 14 days.
- A standardized feeding regimen and intolerance management plan were applied to all neonates.
Main Results:
- No significant difference was observed in the time to achieve full enteral feeds (150 ml/kg/day) between the erythromycin and placebo groups (median 93.5 vs. 104 hours, p = 0.60).
- Baseline characteristics including gestational age, birth weight, and postnatal age at the start of feeds were comparable between groups.
- No erythromycin-related side-effects were reported during the study.
Conclusions:
- Oral prophylactic erythromycin does not appear to accelerate the establishment of full enteral feeds in preterm neonates.
- Erythromycin was well-tolerated in this cohort, with no observed adverse events.
- Further research may be needed to explore other potential benefits or alternative antibiotic strategies in neonatal nutrition.
Abstract:
Efficacy of oral, prophylactic erythromycin in reducing the time to establish full enteral feeds (150 ml/kg/day) was assessed in neonates < 32 weeks, ready for enteral feeds. Seventy-three consecutive neonates were randomised to receive oral erythromycin ethyl succinate (n = 36) or placebo (n = 37) in a double-blind trial until full enteral feeds or 14 days of therapy were reached. A prospectively designed feeding regimen, including plan of action for signs of feed intolerance, was common for all enrolled neonates. The median gestational age, birth weight and postnatal age at start of feeds were 29 versus 30 weeks (p = 0.40), 1232 versus 1280 g (p = 0.96) and 5 versus 5 days (p = 0.84) for erythromycin and placebo group, respectively. Time to achieve full feeds was not significantly different in the two groups. (median times: erythromycin 93.5 versus placebo 104 hours, p = 0.60). Erythromycin-related side-effects did not occur.