Feeding intolerance because of functional gastrointestinal dysmotility, and parenteral nutrition-associated cholestasis are common in preterm, very-low-birth-weight infants.
Dr Pak Ng and colleagues from Hong Kong assessed the effectiveness of ‘high-dose' oral erythromycin as a prokinetic agent in decreasing parenteral nutrition-associated cholestasis.
|Duration of parenteral nutrition was decreased by 10 days|
The team had 2 secondary end points that included the time to achieve full enteral feeding, and the duration of parenteral nutrition, were also evaluated.
The researchers evaluated 182 very-low-birth-weight infants consecutively admitted to the neonatal unit.
The team randomized the patients to receive erythromycin or an equivalent volume of normal saline.
The patients were included if they attained less than half the total daily fluid intake as milk feeds on day 14 of life.
The incidence of parenteral nutrition-associated cholestasis was significantly lower in erythromycin-treated infants compared with placebo infants.
The team noted that infants achieved full enteral nutrition significantly earlier.
The researchers found that the duration of parenteral nutrition was also significantly decreased by 10 days.
The researchers found that fewer infants receiving erythromycin had 2 or more episodes of septicemia compared with placebo patients.
No serious adverse effect was associated with erythromycin treatment.
Dr Ng's team concluded, "High-dose oral erythromycin can be considered as a rescue measure for very-low-birth-weight infants who fail to establish adequate enteral nutrition, and in whom obstructive pathologies of the gastrointestinal tract have been excluded."