Effect of Erythromycin on Gastric Emptying Time of Low Birth Weight Babies

Abstract

Background: To study the promotility effects of low dose erythromycin on gastric emptying time in a population of normal low birth weight (LBW) neonates on breast feeds with or without nutritional supplements and human milk fortifier (HMF). Method: A randomised control trial involving 50 neonates was undertaken and they were given 6mg/kg/day of oral erythromycin or placebo in three divided doses for four consecutive days in the first two weeks of life. The gastric emptying time (GET) was assessed ultrasonographically by measuring the decrease in the antral cross sectional area (ACSA). The time taken for the ACSA to become half the prefeed value, was taken as t/2 or half GET. The babies were also assessed for pre and post intervention side effects of the drug. The results were analysed using SPSS ver 11.5. Results: The test group showed a significant decrease in GET after the intervention. This effect was mainly seen in the preterm babies as compared to term Small for Gestational Age (SGA) babies. The decrease in GET was more in babies born after 34 weeks of gestation as compared to smaller babies. The reduction in GET was seen in babies on breast milk alone and nutritional supplements with breast milk but not when HMF was added. No side effects of the drug were noted. Conclusion: Low dose erythromycin is a safe way of decreasing gastric emptying in preterm babies born after 34 weeks of gestation in the first two weeks of life. MJAFI 2007; 63 : 226-228

Perioperative fasting and feeding in adults, obstetric, paediatric and bariatric population: Practice Guidelines from the Indian Society of Anaesthesiologists

“…[ 258 ] Low dose erythromycin appears to be safe and effective in decreasing gastric emptying in preterm babies born after 34 weeks of gestation in the first two weeks of life (LOE – Moderate). [ 259 ] Oral ranitidine hydrochloride 2 mg/kg is effective in increasing the pH of gastric aspirate in children aged one to six years in the majority of patients though one should expect lack of measurable response in some children (LOE – High). [ 260 ] Gender, age, gastrointestinal pathology or pH-altering medication does not appear to have an effect on the GFV (LOE – Very Low).…”