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Erythromycin and feeding intolerance in premature infants: a randomized trial

H Aly1, H Abdel-Hady, M Khashaba

  • 1Department of Neonatology, The George Washington University Hospital, Washington, DC 20037, USA. haly@mfa.gwu.edu

Journal of Perinatology : Official Journal of the California Perinatal Association
|October 13, 2006
PubMed

Insights

Low-dose oral erythromycin improved feeding tolerance and reduced parenteral nutrition duration in preterm infants over 32 weeks gestation. However, it did not show similar benefits for infants younger than 32 weeks.

Area of Science:

  • Neonatology
  • Pediatric Gastroenterology
  • Pharmacology

Background:

  • Feeding intolerance is a common complication in preterm infants.
  • Early establishment of enteral feeding is crucial for infant growth and development.
  • Parenteral nutrition (PN) is often required but associated with risks.

Purpose of the Study:

  • To assess the efficacy of low-dose oral erythromycin in treating feeding intolerance in preterm infants.
  • To determine if erythromycin can accelerate the achievement of full enteral feeding.
  • To evaluate the impact of erythromycin on the duration of parenteral nutrition.

Main Methods:

  • A prospective, double-blind, randomized, placebo-controlled trial was conducted.
  • Sixty preterm infants with feeding intolerance were randomized to receive either oral erythromycin (1 mg/kg every 8 h) or placebo.
  • Infants were stratified by gestational age (>32 weeks or ≤32 weeks), and outcomes included time to full enteral feeding and duration of PN.

Main Results:

  • In infants with gestational age >32 weeks, erythromycin significantly reduced the time to full enteral feeding (10.5 vs 16.3 days) and the duration of PN.
  • Erythromycin also led to fewer gastric residuals in infants >32 weeks gestation.
  • No significant differences in feeding tolerance or PN duration were observed between erythromycin and placebo groups in infants ≤32 weeks gestation.

Conclusions:

  • Low-dose enteral erythromycin effectively improves feeding tolerance and shortens PN duration in preterm infants with gestational age >32 weeks.
  • The study did not demonstrate a similar benefit for younger preterm infants (≤32 weeks gestation).
  • Further research may be needed to explore erythromycin's role in specific subgroups of preterm infants.
Abstract

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