Erythromycin for Feed Intolerance in Preterm Neonate: A Randomised, Controlled Trial

Almonte, R; Patole, Sanjay; Kadalraja, R; Müller, Reinhold; Whitehall, John

doi:10.1203/00006450-199904020-01641

Cited by 9 publications

(8 citation statements)

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“…It has been shown that 0.75 mg of intravenous erythromycin significantly increased antral motility of the stomach in neonates less than 30 weeks of gestation [1], thus showing functioning motilin receptors. Previous randomised controlled trials using antimicrobial doses (12 mg/kg/6-8-hourly) of erythromycin have failed to demonstrate a beneficial effect on the establishment of full feeds in preterm neonates [7][8][9]. On the other hand in a small study [10] again using antimicrobial doses, a beneficial effect on gastrointestinal dysmotility was observed in 7 preterm infants.…”

Section: Discussionmentioning

confidence: 89%

Effect of Low-Dose Oral Erythromycin on Gastric Aspirates in Ventilated Neonates Less than 32 Weeks of Gestation

Dellagrammaticas¹,

Iacovidou²,

Megaloyanni³

et al. 2002

Neonatology

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In this prospective study, the 24-hour gastric aspirate volume was carefully recorded before, 24 and 48 h after administering 1.7 mg/kg/8-hourly of oral erythromycin to 16 ventilated neonates less than 32 weeks of gestation. Their median gestational age was 28.5 weeks (range 23–31 weeks), their median birthweight was 1,045 g (range 690–1,560 g) and the median day of life at which erythromycin was commenced was 9.5 days (range 4–16 days). Prior to administering erythromycin median 24-hour gastric aspirate volume, expressed as a percentage of the milk volume given over the same period, was 38.5% (range 20.0–100%). It was significantly lower 24 h (median 12%, range 0–41%, p = 0.0004) and 48 h (median 5%, range 0–21%, p = 0.0004) after commencing erythromycin. There was also significant reduction of gastric aspirate volume between 24 and 48 h after commencing erythromycin (p = 0.0024). Milk volume increment over the same period was not significant (p = 0.1022). These preliminary results warrant further evaluation through a randomised controlled trial.

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Section: Discussionmentioning

confidence: 89%

Effect of Low-Dose Oral Erythromycin on Gastric Aspirates in Ventilated Neonates Less than 32 Weeks of Gestation

Dellagrammaticas¹,

Iacovidou²,

Megaloyanni³

et al. 2002

Neonatology

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“…Enriquez et al found that the use of preventive cisapride had no effect in reducing the time required to achieve full enteral feeding in preterm infants, and Patole et al concluded the same using prophylactic carboxymethylcellulose . Stenson et al and Almonte et al failed to show any significant improvement in days to achieve full enteral feeding using preventive high‐dose erythromycin .…”

Section: Discussionmentioning

confidence: 99%

Enemas, suppositories and rectal stimulation are not effective in accelerating enteral feeding or meconium evacuation in low‐birthweight infants: a systematic review

Kamphorst¹,

Sietsma²,

Brouwer

et al. 2016

Acta Paediatrica

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“…Most paediatric studies have focused on the use of erythromycin as a prokinetic agent in premature or low birth‐weight babies 38 –46 . These babies are at risk of morbidity and mortality due to gut immaturity, feeding intolerance and the need for prolonged parenteral nutrition 58 .…”

Section: Prokinetic Activity In Childrenmentioning

confidence: 99%

“…Almonte et al . (1999) performed a randomized, placebo‐controlled trial on 73 pre‐term infants less than or equal to 32 weeks’ gestation, who were ready for enteral feeding 43 . Erythromycin was given at an antibiotic dose (12 mg/kg q.d.s.…”

Section: Prokinetic Activity In Childrenmentioning

confidence: 99%

Erythromycin as a prokinetic agent in infants and children

Curry

Lander²,

Stringer

2001

Aliment Pharmacol Ther

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Erythromycin has been used as an antibiotic for more than four decades, but only in the last 10 years have other therapeutic benefits of this agent been exploited. Animal and human studies have demonstrated a prokinetic effect on the gastrointestinal tract at sub‐antimicrobial doses (typically a quarter or less of the antibiotic dose). A limited number of studies have been performed in children to investigate this action. A review of this literature is particularly pertinent given the frequency of clinical problems related to gastrointestinal dysmotility in children and the limited availability of prokinetic agents in paediatric practice, compounded by the recent withdrawal of cisapride. The prokinetic effects of erythromycin have been investigated in infants with dysmotility associated with prematurity, in low birth‐weight infants recovering from abdominal surgery, and in older children with a variety of other gastrointestinal disorders. Only one randomized placebo‐controlled trial has been conducted. All except one of these studies have shown a beneficial effect of erythromycin in either promoting tolerance of enteral feeds or enhancing a measured index of gastrointestinal motility. Erythromycin appears to be equally effective when given orally (as ethylsuccinate or estolate) or intravenously (as lactobionate). Significantly, no serious adverse effects have been reported in studies in which erythromycin has been used for its prokinetic effects, although fatal reactions have followed the intravenous administration of erythromycin to neonates in antibiotic doses.

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Erythromycin for Feed Intolerance in Preterm Neonate: A Randomised, Controlled Trial

Cited by 9 publications

References 0 publications

Effect of Low-Dose Oral Erythromycin on Gastric Aspirates in Ventilated Neonates Less than 32 Weeks of Gestation

Effect of Low-Dose Oral Erythromycin on Gastric Aspirates in Ventilated Neonates Less than 32 Weeks of Gestation

Enemas, suppositories and rectal stimulation are not effective in accelerating enteral feeding or meconium evacuation in low‐birthweight infants: a systematic review

Erythromycin as a prokinetic agent in infants and children

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