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Effect of erythromycin on feeding intolerance in very low birth weight infants: a preliminary observation
1Department of Pediatrics, China Medical College Hospital, Taichung, Taiwan.
Insights
Erythromycin safely improves enteral feeding intolerance in very low birth weight infants. Further research is recommended to confirm its effects on gastrointestinal motility.
Area of Science:
- Neonatology
- Pediatric Gastroenterology
- Pharmacology
Background:
- Feeding intolerance is a significant challenge in very low birth weight infants.
- Prolonged intolerance can lead to delayed growth and increased complications.
Purpose of the Study:
- To evaluate the efficacy of erythromycin in improving enteral feeding tolerance in very low birth weight infants.
- To assess the safety and impact of erythromycin on feeding parameters.
Main Methods:
- A study involving twenty very low birth weight infants (<1500g) with feeding intolerance.
- Erythromycin administered intravenously with a loading dose followed by a maintenance dose.
- Assessment based on daily net orogastric balance (feed volume minus aspirate volume).
Main Results:
- Infants receiving erythromycin showed a significant increase in net orogastric balance.
- Full enteral feeding was established at a mean of 15.1 days after treatment initiation.
- Erythromycin treatment was associated with improved feeding tolerance and was well-tolerated.
Conclusions:
- Erythromycin is a safe and effective method for improving enteral feeding intolerance in very low birth weight infants.
- Further randomized, controlled trials are suggested to investigate erythromycin's impact on gastrointestinal motility.
Abstract:
To investigate the effect of erythromycin on feeding intolerance in very low birth weight infants, from February 1997 to December 1997 twenty infants weighing less than 1500 g, with prolonged intolerance of enteral feeding, were enrolled in this study. The protocol for erythromycin treatment was: a loading dose of 30 mg/kg/day, divided into three portions given every eight hours intravenously for 1 hour over a three day period; then a maintenance dose of 3-5 mg/kg intravenously for one hour once a day was given until full feeding was well established. The assessment of erythromycin effect was the daily net orogastric balance (volume of orogastric tube feeding minus volume of orogastric aspirates). The mean gestational age was 27.1 +/- 2.0 weeks (mean +/- SD) and the mean birth weight was 1025 +/- 196 g. The mean age when erythromycin started was 19.5 +/- 14 days; the mean days after the initiation of erythromycin when orogastric tube feeding could be started and full feeding established were 2.4 +/- 1.1 days and 15.1 +/- 2.2 days, respectively. At the beginning of erythromycin treatment, the net balance of tube aspirates was -4.8 +/- 4.1 ml. The net balance rose significantly to 30.6 +/- 15.3 ml, 92.6 +/- 25.4 ml and 125.3 +/- 18.1 ml at 7, 14 and 21 days after erythromycin treatment, respectively. In conclusion, erythromycin treatment is a safe method to improve intolerance of enteral feeding in very low birth weight infants. It is suggested that the effect of erythromycin on gastrointestinal motility in these infants should be further investigated in the context of a randomized, controlled trial before widespread clinical implementation of this treatment.