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Intravenous low-dose erythromycin administration for infants with feeding intolerance
K Nogami1, T Nishikubo, H Minowa
1Neonatal Intensive Care Unit, Perinatal Medical Center, Nara Prefectural Hospital, 1-30-1 Hiramatsu-cho, Nara-City, Nara, 631-0846, Japan.
Insights
Low-dose intravenous erythromycin (EM) effectively treats feeding intolerance in infants, including premature babies. This safe treatment accelerates successful enteral feeding and improves digestive issues.
Area of Science:
- Neonatalogy
- Pediatric Gastroenterology
- Pharmacology
Background:
- Infants, particularly premature neonates, frequently experience feeding intolerance.
- Enteral feeding is crucial for infant growth and development.
- Existing treatments for feeding intolerance have limitations.
Purpose of the Study:
- To evaluate the efficacy and safety of low-dose intravenous erythromycin (EM) for treating feeding intolerance in infants.
- To compare the outcomes of infants receiving EM with a control group.
Main Methods:
- A study involving 26 infants with feeding intolerance was conducted.
- Fourteen infants received intravenous EM (1 mg/kg, thrice daily, with dose increase if needed).
- Twelve infants served as a non-EM control group.
Main Results:
- EM group showed significant improvement in digestive issues and X-ray findings.
- Successful enteral feeding started significantly earlier in the EM group (9.1 days vs. 14.0 days).
- No adverse cardiac or blood effects were observed with EM treatment.
Conclusions:
- Intravenous low-dose erythromycin is a safe and effective treatment for infant feeding intolerance.
- This therapy is beneficial even for extremely low-birthweight infants.
- EM facilitates earlier achievement of adequate enteral nutrition.
Background:
This study was undertaken to determine the efficacy of low-dose intravenous erythromycin (EM) administration in infants with feeding intolerance.
Methods:
The subjects were 26 infants who would not accept enteral feeding within 5 days after birth. Fourteen infants (gestational age: 30.6+/-5.4 weeks and birthweight: 1466+/-825 g) were given EM intravenously at a dose of 1 mg/kg, three times daily (EM group). Doses were increased to 2 mg/kg in five infants who showed a poor response. Twelve infants (gestational age: 30.5+/-5.0 weeks and birthweight: 1317+/-672 g) were observed without EM administration (non-EM group). Blood concentrations of EM at 2 h after administration were measured on 8 (+/-2) days after the start of EM administration in the EM group.
Results:
Digestive perturbations and intestinal gasless and/or atonic shadows on X-ray findings markedly improved in the EM group soon after the treatment. Comparing the EM group and non-EM group, the postnatal ages at the start of successful enteral feeding were 9.1+/-3.2 days and 14.0+/-4.1 days, respectively (P<0.01). The postnatal ages at feeding of 100 mL/kg per day were 15.2+/-4.0 days and 23.4+/-6.2 days, respectively (P<0.01). The blood EM concentrations of 1 mg/kg and 2 mg/kg were 0.29+/-0.28 microg/mL and 0.57+/-0.20 microg/mL, respectively (P<0.05). No adverse effect on cardiac status or in blood examinations was observed in any infant in the EM group.
Conclusion:
These results suggest that intravenous low-dose EM administration is a useful and safe treatment of feeding intolerance in infants including extremely low-birthweight infants.