Arch. Dis. Child

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER
[Advanced]

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
adc.2004.065250v1
90/4/F301    most recent
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this link to a friend
Right arrow Similar articles in ADC Online
Right arrow Similar articles in PubMed
Right arrow Add article to my folders
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Patole, S
Right arrow Articles by Doherty, D
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Patole, S
Right arrow Articles by Doherty, D
Topic Collections
Right arrowRelevant Article
Archives of Disease in Childhood Fetal and Neonatal Edition 2005;90:F301-FF306
© 2005 Archives of Disease in Childhood Fetal and Neonatal Edition


ORIGINAL ARTICLE

Erythromycin as a prokinetic agent in preterm neonates: a systematic review

S Patole1, S Rao1, D Doherty2

1 Department of Neonatal Paediatrics, King Edward Memorial Hospital for Women, University of Western Australia, Perth, Western Australia
2 Women and Infants Research Foundation at King Edward Memorial Hospital for Women and School of Women’s and Infant’s Health at University of Western Australia

Correspondence to:
Correspondence to:
Dr Patole
Department of Neonatal Paediatrics, KEM Hospital for Women, University of Western Australia, Perth, Western Australia 6008; skpatole{at}hotmail.com

Background: It often takes several days or even weeks to establish full enteral feeds (FEFs) in preterm, especially extremely low birthweight neonates because of feed intolerance related to gastrointestinal hypomotility. Clinical trials of erythromycin as a prokinetic agent in preterm neonates have reported conflicting results.

Aim: To systematically review the efficacy and safety of erythromycin as a prokinetic agent in preterm neonates.

Methods: Only randomised controlled trials in preterm neonates (gestation <=37 weeks) were considered eligible for inclusion. The primary outcome was the time to reach FEFs of 150 ml/kg/day. The secondary outcomes included the incidence of erythromycin related adverse effects such as diarrhoea, cardiac arrhythmias, and hypertrophic pyloric stenosis. No restrictions were applied on the dose (low: 3–12 mg/kg/day; antimicrobial: >=12 mg/kg/6–8 hours) and route (oral or intravenous) and mode (prophylactic or rescue) of administration. The standard methodology for systematic reviews was followed. A subgroup analysis was preplanned based on the dose and mode of drug administration.

Results: Seven trials (three prophylaxis, four rescue) with various doses, routes and modes of administration, and durations of erythromycin treatment and different results were found to be eligible for inclusion in the analysis. Meta-analysis could not be performed, as specific data were either inadequate or not available.

Conclusion: The conflicting trial results may be explained by differences in dose and route and mode of administration of erythromycin and in gastrointestinal motor responses in the presence of different feeding conditions—for example, fasting v fed state, intermittent v continuous feeds. Gestational and postnatal ages during erythromycin treatment are also important.


Abbreviations: FEF, full enteral feed; MMC, migrating motor complex

Keywords: enteral; erythromycin; feeding; preterm


Relevant Article

Fantoms
Martin Ward Platt
Arch. Dis. Child. Fetal Neonatal Ed. 2005 90: F283. [Extract] [Full Text] [PDF]






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER
ARCH DIS CHILD FETAL NEONATAL ED ED PRACTICE
Terms and conditions relating to subscriptions purchased online  ¦  Website terms and conditions  ¦  Privacy policy
Copyright © 2005 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health