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A pioneering study: oral clarithromycin treatment for feeding intolerance in very low birth weight preterm infants

Selim Sancak1, Tugba Gursoy2, Abdulhamit Tuten1

  • 1a Neonatal Intensive Care Unit , Zeynep Kamil Maternity and Children's Training and Research Hospital , Istanbul , Turkey.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|March 11, 2017
PubMed

Insights

Clarithromycin improved enteral feeding tolerance in very low birth weight preterm infants. This antibiotic enhanced feeding advancement and reduced parenteral nutrition duration, showing promise for clinical use.

Area of Science:

  • Neonatalogy
  • Pharmacology
  • Gastroenterology

Background:

  • Feeding intolerance is a significant challenge in very low birth weight (VLBW) preterm infants.
  • Delayed enteral feeding advancement can lead to increased morbidities and prolonged hospitalization.

Purpose of the Study:

  • To investigate the prokinetic effect of clarithromycin in VLBW preterm infants.
  • To assess if clarithromycin can accelerate enteral feeding advancement.

Main Methods:

  • A randomized controlled trial involving VLBW preterm infants with feeding difficulties.
  • Infants were randomized to receive oral clarithromycin (7.5 mg/kg twice daily) or a placebo.
  • Outcomes included time to full enteral feeding, duration of parenteral nutrition, and feeding intolerance events.

Main Results:

  • Clarithromycin group achieved full enteral feeding significantly earlier than controls [7 vs. 9 days].
  • The duration of parenteral nutrition and number of withheld feeds were significantly reduced in the clarithromycin group.
  • No significant adverse effects were observed with clarithromycin treatment.

Conclusions:

  • Clarithromycin demonstrates a prokinetic effect, improving enteral feeding tolerance in VLBW preterm infants.
  • Further large-scale randomized controlled trials are warranted to confirm these findings and establish routine use.
Abstract

Keywords:
Clarithromycinfeeding intolerancegastrointestinal dysmotilitypremature infantsprokinetic

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