title: A pioneering study: oral clarithromycin treatment for feeding intolerance in very low birth weight preterm infants.
abstract: OBJECTIVE
  To examine the prokinetic effect of clarithromycin in very low birth weight (VLBW) preterm infants.
  
  
  METHODS
  VLBW preterm infants who have not achieved half of the full enteral feeding in the second week of life were enrolled in the study. The infants enrolled in the study were randomized. Twenty infants received oral clarithromycin (7.5 mg/kg, twice a day) and 20 control infants did not receive any treatment.
  
  
  RESULTS
  Full enteral feeding was attained earlier in the clarithromycin group than in the control group [7 (6-9) versus 9 (9-11) days, respectively; p < .001]. Duration of parenteral nutrition and number of withheld feeds were significantly lower in the clarithromycin group (p = .013 and p < .001, respectively). Parenteral nutrition-associated cholestasis (n = 1 versus 3, p = .1) and length of hospital stay (50 versus 59 median days, p = .1) tend to be lower in the clarithromycin group without any statistical significance. We observed no adverse effect of clarithromycin therapy.
  
  
  CONCLUSIONS
  Clarithromycin treatment in VLBW preterm infants resulted in better toleration of enteral feeding. Larger randomized controlled trials are needed to establish routine use of clarithromycin in the treatment of feeding intolerance.
authors.affiliation: a Neonatal Intensive Care Unit , Zeynep Kamil Maternity and Children's Training and Research Hospital , Istanbul , Turkey.
authors.forename: Selim
authors.identifier: http://orcid.org/0000-0003-3952-9203
authors.initials: S
authors.lastname: Sancak
authors.affiliation: b Neonatal Intensive Care Unit , Koc University School of Medicine , Istanbul , Turkey.
authors.forename: Tugba
authors.initials: T
authors.lastname: Gursoy
authors.affiliation: a Neonatal Intensive Care Unit , Zeynep Kamil Maternity and Children's Training and Research Hospital , Istanbul , Turkey.
authors.forename: Abdulhamit
authors.initials: A
authors.lastname: Tuten
authors.affiliation: a Neonatal Intensive Care Unit , Zeynep Kamil Maternity and Children's Training and Research Hospital , Istanbul , Turkey.
authors.forename: Didem
authors.initials: D
authors.lastname: Arman
authors.affiliation: a Neonatal Intensive Care Unit , Zeynep Kamil Maternity and Children's Training and Research Hospital , Istanbul , Turkey.
authors.forename: Guner
authors.initials: G
authors.lastname: Karatekin
authors.affiliation: c Neonatal Intensive Care Unit , Medeniyet University , Istanbul , Turkey.
authors.forename: Fahri
authors.initials: F
authors.lastname: Ovali
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D017291:Clarithromycin / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D000073923:Food Intolerance / Q000188:drug therapy*; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D017291:Clarithromycin
keywords: Clarithromycin; feeding intolerance; gastrointestinal dysmotility; premature infants; prokinetic