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Erythromycin as a prokinetic agent in preterm infants.
Christos Costalos1, Anthony Gounaris, Evangelia Varhalama
1Department of Neonatal Medicine, Piraeus General Hospital, Nikea, Piraeus, Greece.
Journal of Pediatric Gastroenterology and Nutrition
|December 26, 2001
Summary
Erythromycin significantly enhances gastrointestinal motility in preterm infants. This macrolide antibiotic improved antral contractility and reduced whole gut transit time, aiding digestion.
Area of Science:
- Neonatal Medicine
- Pharmacology
- Gastroenterology
Background:
- Erythromycin, a macrolide antibiotic, is recognized for its prokinetic properties, stimulating gastrointestinal motility.
- Preterm infants often experience gastrointestinal dysmotility, necessitating effective therapeutic interventions.
Purpose of the Study:
- To investigate the impact of oral erythromycin on the gastrointestinal motility of preterm infants.
- To evaluate erythromycin's efficacy in enhancing gastric antral contractility and whole gut transit time.
Main Methods:
- A double-blind, randomized, crossover study involving 20 preterm infants (median gestational age 32 weeks).
- Infants received either erythromycin (10 mg/kg, 8-hourly) or placebo orally for 7 days.
- Gastric antral contractility was measured using ultrasonography; whole gut transit time was assessed via carmine red transit.
Main Results:
- Erythromycin treatment significantly reduced the duration of antral contractility compared to placebo (31 min vs. 70 min, P < 0.01).
- Whole gut transit time was markedly shorter with erythromycin (23.1 hours vs. 49.3 hours, P < 0.01).
- All infants tolerated erythromycin well, with no adverse events reported.
Conclusions:
- Oral erythromycin effectively enhances both antral contractility and whole gut transit time in food-intolerant preterm infants.
- Erythromycin presents a promising therapeutic option for managing gastrointestinal dysmotility in this vulnerable population.