Intravenous low-dose erythromycin administration for infants with feeding intolerance.
BACKGROUND
This study was undertaken to determine the efficacy of low-dose intravenous erythromycin (EM) administration in infants with feeding intolerance.


METHODS
The subjects were 26 infants who would not accept enteral feeding within 5 days after birth. Fourteen infants (gestational age: 30.6+/-5.4 weeks and birthweight: 1466+/-825 g) were given EM intravenously at a dose of 1 mg/kg, three times daily (EM group). Doses were increased to 2 mg/kg in five infants who showed a poor response. Twelve infants (gestational age: 30.5+/-5.0 weeks and birthweight: 1317+/-672 g) were observed without EM administration (non-EM group). Blood concentrations of EM at 2 h after administration were measured on 8 (+/-2) days after the start of EM administration in the EM group.


RESULTS
Digestive perturbations and intestinal gasless and/or atonic shadows on X-ray findings markedly improved in the EM group soon after the treatment. Comparing the EM group and non-EM group, the postnatal ages at the start of successful enteral feeding were 9.1+/-3.2 days and 14.0+/-4.1 days, respectively (P<0.01). The postnatal ages at feeding of 100 mL/kg per day were 15.2+/-4.0 days and 23.4+/-6.2 days, respectively (P<0.01). The blood EM concentrations of 1 mg/kg and 2 mg/kg were 0.29+/-0.28 microg/mL and 0.57+/-0.20 microg/mL, respectively (P<0.05). No adverse effect on cardiac status or in blood examinations was observed in any infant in the EM group.


CONCLUSIONS
These results suggest that intravenous low-dose EM administration is a useful and safe treatment of feeding intolerance in infants including extremely low-birthweight infants.
Nogami
K
K
Neonatal Intensive Care Unit, Perinatal Medical Center, Nara Prefectural Hospital, 1-30-1 Hiramatsu-cho, Nara-City, Nara, 631-0846, Japan.
Nishikubo
T
T
Minowa
H
H
Uchida
Y
Y
Kamitsuji
H
H
Takahashi
Y
Y
D004750:Enteral Nutrition; D004917:Erythromycin / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage* / Q000494:pharmacology; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000503:physiopathology; D007262:Infusions, Intravenous; D008297:Male; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D004917:Erythromycin