A team from Tennessee, USA, assessed the link between very early erythromycin exposure and pyloric stenosis in young infants.
Births registered by Medicaid or TennCare (Tennessee's program for Medicaid enrollees and uninsured individuals) in Tennessee from 1985 to 1997 were included in the retrospective study.
Cases of infants with a hospital discharge diagnosis of pyloric stenosis and an associated surgical procedure code were used.
Erythromycin exposure and other antibiotic exposure between 3 and 90 days of life were identified from prescription files.
| Erythromycin given between 3 and 13 days of life linked to increased pyloric stenosis risk.
| Archives of Pediatrics & Adolescent Medicine |
Of 933,239 births in Tennessee during the study period, 314,029 were enrolled in Medicaid.
Among these infants, 804 (0.26%) met the criteria for pyloric stenosis.
Very early exposure to erythromycin (between 3 and 13 days of life) was associated with a nearly 8-fold increased risk of pyloric stenosis (adjusted incident rate ratio, 7.9).
However, no increased risk of pyloric stenosis was seen in infants exposed to erythromycin after 13 days of life, or in infants exposed to antibiotics other than erythromycin.
Dr William O. Cooper, of the Vanderbilt University, Nashville, Tennessee, said on behalf of his colleagues, " The significant increase in pyloric stenosis in children with very early exposure to erythromycin is consistent with reports of other investigators."
"The risks and benefits of erythromycin should be weighed carefully prior to initiating such therapy in young infants," he concluded.