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Efficacy of intermediate-dose oral erythromycin on very low birth weight infants with feeding intolerance

Yan-Yan Ng1, Pen-Hua Su, Jia-Yuh Chen

  • 1Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.

Pediatrics and Neonatology
|February 22, 2012
PubMed

Insights

Intermediate-dose oral erythromycin effectively treats feeding intolerance in very low birth weight (VLBW) infants. This treatment reduced time to full feeding and lowered risks of parenteral nutrition-associated cholestasis and necrotizing enterocolitis.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Pharmacology

Background:

  • Erythromycin is a prokinetic agent used for feeding intolerance in preterm infants.
  • Previous studies show varied results due to differences in dosage, administration, and duration.
  • This study focuses on intermediate-dose oral erythromycin for very low birth weight (VLBW) infants.

Purpose of the Study:

  • To evaluate the effectiveness and safety of intermediate-dose oral erythromycin.
  • To assess its impact on feeding intolerance in VLBW infants.

Main Methods:

  • 45 VLBW infants (≥14 days old) with feeding intolerance were enrolled.
  • Treatment group (n=19): 5mg/kg oral erythromycin every 6 hours for 14 days.
  • Control group (n=26): No erythromycin administration.

Main Results:

  • Erythromycin group achieved full enteral feeding faster (36.5 vs. 54.7 days, p=0.01).
  • Shorter duration of parenteral nutrition and time to reach 2500g body weight in the erythromycin group (p<0.05).
  • Lower incidence of parenteral nutrition-associated cholestasis (PNAC) and stage II necrotizing enterocolitis (NEC) (p<0.05).

Conclusions:

  • Intermediate-dose oral erythromycin is safe and effective for VLBW infants with feeding intolerance.
  • Significantly reduced rates of PNAC and stage II NEC observed with erythromycin treatment.
  • No significant differences in sepsis, bronchopulmonary dysplasia, or retinopathy of prematurity.
Abstract

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