Randomized controlled trial of a high dose of oral erythromycin for the treatment of feeding intolerance in preterm infants.

Author(s): Mansi Y, Abdelaziz N, Ezzeldin Z, Ibrahim R

Affiliation(s): Department of Pediatrics, Faculty of Medicine, University of Cairo, Cairo, Egypt. y_mansi@yahoo.com

Publication date & source: 2011, Neonatology., 100(3):290-4. Epub 2011 Jun 23.

OBJECTIVES: To evaluate the effectiveness of high-dose erythromycin to treat feeding intolerance in preterm infants predominantly fed milk formula. DESIGN: This study is a prospective randomized controlled trial on 60 premature infants suffering from feeding intolerance. Thirty infants were given oral erythromycin ethylsuccinate at a dose of 50 mg/kg/day for 10 days or until they reached full enteral feeds. Randomization was stratified according to gestational age <32 weeks or >/=32 weeks gestation. The primary end point was the time taken to establish full enteral feeding since enrollment. Potential adverse effects associated with erythromycin were also monitored. Student's t test was used for comparison of continuous variables and chi(2)for categorical data. RESULTS: In infants <32 weeks, the use of erythromycin was associated with more daily weight gain (12.8 +/- 2.6 g vs. 9.2 +/- 5.3 g, p = 0.04) compared to the control group. Time to reach full feed did not differ between the erythromycin (13.8 +/- 3.9 days) and the control (17.46 +/- 4.9 days) groups (p = 0.07). In infants >/=32 weeks, there were no differences between the erythromycin and the control groups. CONCLUSION: High-dose erythromycin is associated with greater weight gain in preterm infants <32 weeks gestational age, who are predominantly fed cow's milk-based protein formulas. Copyright (c) 2011 S. Karger AG, Basel.