Failure of erythromycin to eliminate airway colonization with ureaplasma urealyticum in very low birth weight infants.
BACKGROUND
Airway colonization of mechanically ventilated very low birth weight infants (birth weight < 1500 grams) by Ureaplasma urealyticum (Uu) is associated with an increased risk of bronchopulmonary dysplasia (BPD). While Uu is sensitive to erythromycin in vitro, the efficacy of intravenous (IV) erythromycin to eliminate Uu from the airways has not been studied.


METHODS
17 very low birth weight infants with Uu positive tracheal aspirate (TA) cultures were randomized to either 5 (8 infants) or 10 days (9 infants) of IV erythromycin lactobionate (40 mg/kg/day in 3 divided doses). Tracheal aspirate cultures for Uu were performed on days 0, 5, 10 and 15.


RESULTS
Intravenous erythromycin failed to eliminate airway colonization in a large proportion of infants regardless of whether they received 5 or 10 days of treatment. Ureaplasma urealyticum was isolated from 4/15 (27%) of TAs obtained at 5 days, 5/12 TAs (42%) obtained at 10 days and 6/11(55%) TAs obtained at 15 days (combined group data).


CONCLUSIONS
Erythromycin administered IV does not eliminate Uu from the airways in a large proportion of infants. Failure of erythromycin to eliminate Uu from the airways may contribute to the lack of efficacy of this drug in reducing the incidence of BPD in very low birth weight infants.
Baier
R John
RJ
Department of Pediatrics, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, Louisiana 71130-3932, USA. jbaier@lsuhsc.edu
Loggins
John
J
Kruger
Thomas E
TE
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004917:Erythromycin / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D011446:Prospective Studies; D012121:Respiration, Artificial; D012137:Respiratory System / Q000382:microbiology*; D017211:Treatment Failure; D016990:Ureaplasma urealyticum / Q000187:drug effects*
D000900:Anti-Bacterial Agents; D004917:Erythromycin