Erythromycin as a prokinetic agent in preterm infants.
BACKGROUND
The macrolide antibiotic erythromycin is a prokinetic agent that stimulates gastrointestinal motility. The aim of the study was to determine the effect of erythromycin on the gastrointestinal motility of preterm infants.


METHODS
Erythromycin 10 mg/kg, 8 hourly or a placebo, was given orally for 7 days in a double-blind randomized, crossover study of 20 preterm infants with a median gestational age of 32 weeks (range, 26-34 weeks). Antral contractility was determined by using ultrasonography to measure the decrease in the gastric antral cross-sectional area after a feed. The whole gut transit time was assessed by timing the transit of carmine red through the gut.


RESULTS
Antral contractility lasted for a shorter period of time during erythromycin treatment than during placebo treatment (mean [standard deviation], 31 minutes [9.9 minutes] vs. 70 minutes [13 minutes]; P < 0.01). Whole gut transit time was also shorter during erythromycin treatment (mean, 23.1 hours [12.9 hours] vs. 49.3 hours [29 hours]; P < 0.01). All infants tolerated the drug well.


CONCLUSIONS
Oral erythromycin in food-intolerant preterm infants enhances both antral contractility and whole gut transit time.
Costalos
Christos
C
Department of Neonatal Medicine, Piraeus General Hospital, Nikea, Piraeus, Greece.
Gounaris
Anthony
A
Varhalama
Evangelia
E
Kokori
Fedra
F
Alexiou
N
N
Kolovou
Efi
E
D000284:Administration, Oral; D002329:Carmine; D004396:Coloring Agents; D018592:Cross-Over Studies; D003430:Cross-Sectional Studies; D004064:Digestive System / Q000187:drug effects; D004068:Digestive System Physiological Phenomena; D004311:Double-Blind Method; D004917:Erythromycin / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D005765:Gastrointestinal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D005769:Gastrointestinal Motility / Q000187:drug effects* / Q000502:physiology; D005772:Gastrointestinal Transit / Q000187:drug effects* / Q000502:physiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D008297:Male; D011706:Pyloric Antrum / Q000000981:diagnostic imaging; D014463:Ultrasonography
D004396:Coloring Agents; D005765:Gastrointestinal Agents; D004917:Erythromycin; D002329:Carmine