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Archives of Disease in Childhood - Fetal and Neonatal Edition 1998;78:F10-F14; doi:10.1136/fn.78.1.F10
Copyright © 1998 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.
Arch Dis Child Fetal Neonatal Ed 1998;78:F10-F14 ( January )

Randomised trial of erythromycin on the development of chronic lung disease in preterm infants

A J Lyon,a J McColm,b L Middlemist,b S Fergusson,c N McIntosh,b P W Rossc

a Neonatal Unit, Simpson Memorial Maternity Pavilion, Lauriston Place, Edinburgh EH3 9YW, b Department Child Life and Health, University of Edinburgh, c Department Medical Microbiology, University of Edinburgh

Correspondence to: Dr A J Lyon.


Accepted 2 July 1997

AIMS---To determine if erythromycin given from birth reduces the inflammatory response and the incidence and severity of chronic lung disease.
METHODS---Seventy five infants less than 30 weeks of gestation and ventilated from birth for lung disease were randomly assigned to receive erythromycin intravenously for 7 days or to no treatment. Ureaplasma urealyticum was detected in tracheal secretions by culture and polymerase chain reaction. Differential cell counts were obtained from bronchoalveolar lavage fluid collected daily for 5 days and concentrations of the cytokines interluekins IL-1beta and IL-8, and tumour necrosis factor alpha  (TNF-alpha ) were measured. Chronic lung disease (CLD) was defined as oxygen dependency at 36 weeks of gestation.
RESULTS---Nine infants (13%) were positive for U urealyticum. The inflammatory cytokines in the lungs increased over the first 5 days of life in all babies, but no association was found between their concentrations and the development of CLD. Those treated with erythromycin showed no significant differences from the non- treated group in the differential cell counts or concentrations of the cytokines. The two groups had a similar incidence of CLD. Babies infected with U urealyticum did not have a more pronounced cytokine response than those without infection. Chorioamnionitis was associated with significantly higher concentrations of IL-1beta and IL-8 on admission: these babies had less severe acute lung disease and developed significantly less CLD.
CONCLUSIONS---U urealyticum in the trachea was not associated with an increased inflammatory response in preterm infants. Erythromycin did not reduce the incidence or severity of CLD.

Keywords: chronic lung disease; Ureaplasma urealyticum; erythromycin; cytokines


© 1998 by Archives of Disease in Childhood

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