title: Efficacy of intermediate-dose oral erythromycin on very low birth weight infants with feeding intolerance.
abstract: BACKGROUND
  Erythromycin is generally used as a prokinetic agent for the treatment of feeding intolerance in preterm infants; however, results from previous studies significantly vary due to different medication dosages, routes of administration, and therapy durations. The effectiveness and safety of intermediate-dose oral erythromycin in very low birth weight (VLBW) infants with feeding intolerance was examined in this study.
  
  
  METHODS
  Between November 2007 and August 2009, 45 VLBW infants with feeding intolerance, who were all at least 14 days old, were randomly allocated to a treatment group and administered 5mg/kg oral erythromycin every 6hours for 14 days (n=19). Another set of randomly selected infants was allocated to the control group, which was not administered erythromycin (n=26).
  
  
  RESULTS
  The number of days required to achieve full enteral feeding (36.5±7.4 vs. 54.7±23.3 days, respectively; p=0.01), the duration of parenteral nutrition (p<0.05), and the time required to achieve a body weight ≥2500g (p<0.05) were significantly shorter in the erythromycin group compared with the control group. The incidence of parenteral nutrition-associated cholestasis (PNAC) and necrotizing enterocolitis (NEC) ≥ stage II after 14 days of treatment were significantly lower (p<0.05) in the erythromycin group. No significant differences were observed in terms of the incidences of sepsis, bronchopulmonary dysplasia, or retinopathy of prematurity. No adverse effects were associated with erythromycin treatment.
  
  
  CONCLUSIONS
  Intermediate-dose oral erythromycin is effective and safe for the treatment of feeding intolerance in VLBW infants. The incidences of PNAC and ≥ stage II NEC were significant lower in the erythromycin group.
authors.affiliation: Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Yan-Yan
authors.initials: YY
authors.lastname: Ng
authors.forename: Pen-Hua
authors.initials: PH
authors.lastname: Su
authors.forename: Jia-Yuh
authors.initials: JY
authors.lastname: Chen
authors.forename: Yeak-Wun
authors.initials: YW
authors.lastname: Quek
authors.forename: Jui-Ming
authors.initials: JM
authors.lastname: Hu
authors.forename: Inn-Chi
authors.initials: IC
authors.lastname: Lee
authors.forename: Hong-Shen
authors.initials: HS
authors.lastname: Lee
authors.forename: Hua-Pin
authors.initials: HP
authors.lastname: Chang
mesh_terms: D000284:Administration, Oral; D004917:Erythromycin / Q000008:administration & dosage*; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects; D057947:Parenteral Nutrition Solutions; D015430:Weight Gain
chemical_list: D005765:Gastrointestinal Agents; D057947:Parenteral Nutrition Solutions; D004917:Erythromycin