Efficacy of oral erythromycin for treatment of feeding intolerance in preterm infants

Use of Oral Erythromycin for the Treatment of Gastrointestinal Dysmotility in Preterm Infants

“…Nonetheless, no improvement was observed in infants with lower gestational ages. In contrast, all studies utilizing an intermediate or a high dose of oral erythromycin showed beneficial effects in promoting milk feedings and shortening the duration of parenteral nutrition requirements [17][18][19] . Additionally, the clinical outcome study has sufficient statistical power to demonstrate that use of erythromycin could reduce the incidence of PNAC by almost half (49%) and with significantly fewer treated patients having abnormally raised serum alanine aminotransferase concentration [19] .…”

“…Four clinical trials used low doses (3-15 mg/kg/day administered either orally or intravenously) [13][14][15][16] , whereas the other 3 trials used either an intermediate/ high dose tapering regimen (40 mg/kg for 2 days followed by 16 mg/kg for 5 days) [17] or high doses (50 mg/day) [18,19] . It is worth noting that all patients in the 'pilot' study by Ng et al [18] were included in the final analysis of their 'outcome' study [19] .…”

“…The overall pattern suggested that the discrepancy of results between studies could have been related to the small sample size in some clinical trials [13,14] , as well as the different dosages used. It appears that in rescue therapy, the intermediate and high doses are probably more effective in stimulating the human GI tract and promoting milk feeding in preterm infants [17][18][19] . Comments -infants received erythromycin emptied 47823% of their feeding in 20 min, whereas infants received placebo emptied 32820%; 70820% vs. 64826% within one hour, respectively -antroduodenal motor contractions were similar in both groups -a higher proportion of infants in the placebo group (7/11, 64%) had PNAC than those in the erythromycin group (4/13, 31%; p = 0.11)…”

A controlled trial of erythromycin and UDCA in premature infants during parenteral nutrition in minimizing feeding intolerance and liver function abnormalities

“…Our study demonstrated that erythromycin-treated infants had significantly fewer episodes of large residual gastric aspirates and were able to attain FEF more quickly, as noted in other. 24,26 Thus, we suggest that the use of an intermediate dose of oral erythromycin could significantly reduce the number of withheld feeds and the time of FEF. 23 The main limitation of our study was that it was underpowered.…”

“…Although it should be noted that in some studies, no significant difference was found between the placebo and erythromycin groups. [23][24][25] When we compared GGT level between the UDCA and erythromycin groups after treatment, GGT level was found to be A comparison of erythromycin and UDCA in premature infants T Gokmen et al significantly higher in the erythromycin group. Our findings suggest that UDCA was the most effective agent for preventing cholestasis.…”