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Use of prokinetics in the preterm infant

Hugh S Lam1, Pak C Ng

  • 1Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.

Current Opinion in Pediatrics
|December 24, 2010
PubMed

Insights

High-dose erythromycin may benefit premature infants with gastrointestinal dysmotility when used as rescue therapy. Lower doses and prophylactic use showed no benefit, but risks like antibiotic resistance require further study.

Area of Science:

  • Neonatalogy
  • Gastroenterology
  • Pharmacology

Background:

  • Functional gastrointestinal dysmotility is common in premature infants.
  • Delayed enteral nutrition increases risks associated with parenteral nutrition.
  • Conflicting evidence exists on prokinetic agents for preterm infants.

Purpose of the Study:

  • Evaluate studies on prokinetic agents in preterm infants.
  • Determine if these agents are beneficial and justified.
  • Assess the efficacy of erythromycin for gastrointestinal dysmotility.

Main Methods:

  • Review of randomized controlled trials.
  • Investigation of erythromycin effectiveness.
  • Analysis of low-dose, prophylactic, and high-dose regimens.

Main Results:

  • Low-dose and prophylactic erythromycin were not effective.
  • High-dose erythromycin as rescue therapy showed clinical benefit.
  • Potential risks like antibiotic resistance were not fully evaluated.

Conclusions:

  • High-dose erythromycin as rescue therapy is likely justifiable.
  • Further research is needed for safer prokinetic agents.
  • Development of novel agents with improved safety profiles is warranted.
Abstract

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