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Erythromycin improves gastrointestinal motility in extremely low birthweight infants
M Kubota1, T Nakamura, T Motokura
1Department of Neonatology, Metropolitan Hachioji Children's Hospital, Tokyo, Japan.
Insights
Erythromycin (EM) safely improved gastrointestinal motility in extremely low birthweight infants (ELBWI) with feeding delays. This intervention facilitated earlier enteral feeding, reducing the risk of nutrient deprivation in vulnerable infants.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Pharmacology
Background:
- Extremely low birthweight infants (ELBWI) often experience delayed enteral feeding due to severely impaired gastrointestinal motility.
- Prolonged ventilator support in ELBWI increases the risk of nutrient deprivation.
- Erythromycin (EM) has prokinetic properties that may benefit gastrointestinal function.
Purpose of the Study:
- To evaluate the clinical efficacy of Erythromycin (EM) in improving gastrointestinal motility in ELBWI with delayed enteral feeding.
- To assess the safety and impact of EM on facilitating enteral nutrition in this high-risk infant population.
Main Methods:
- A case series involving five ELBWI with delayed enteral feeding.
- Administration of intravenous Erythromycin (EM), with a loading dose (15-30 mg/kg/day) followed by a maintenance dose (3-5 mg/kg/day) in four infants.
- One infant received EM without a loading dose.
- Clinical observation for response and adverse effects.
Main Results:
- All five ELBWI responded positively to Erythromycin (EM) administration.
- No adverse effects were observed during the treatment course.
- Enteral feeding was initiated significantly earlier, within 2 to 6 days of starting EM therapy.
- The infants' gastrointestinal motility improved, allowing for timely nutritional support.
Conclusions:
- Erythromycin (EM) administration is a safe and effective therapeutic strategy for enhancing gastrointestinal motility in ELBWI.
- Facilitating earlier enteral feeding with EM can mitigate the risk of nutrient deprivation in ELBWI requiring prolonged mechanical ventilation.
Abstract:
Erythromycin (EM) was administered to five extremely low birthweight infants (ELBWI) with delayed enteral feeding to evaluate the clinical effect on severely impaired gastrointestinal motility. Five patients studied responded well to EM administration without any adverse effects during the course. Four patients were given 15-30 mg/kg per day EM intravenously as a loading and thereafter 3-5 mg/kg per day as a maintenance dose. One patient responded well without loading. The infants could be fed enterally 4, 5, 6, 4 and 2 days after the initiation of EM administration, respectively. Erythromycin administration is a safe and useful way to facilitate gastrointestinal motility in ELBWI who require prolonged ventilator support with an increased risk for nutrient deprivation.