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Erythromycin and gastrointestinal dysmotility in preterm infants

Year 2010, Volume: 15 Issue: 4, 146 - 150, 17.01.2013

Abstract

 

Abstract. Gastrointestinal dysmotility is a common condition in preterm infants due to immature development of gastrointestinal peristalsis. Erythromycin, with its motilinomimetric effect, has been used to facilitate enteral feeding in preterm infants. Various regimens, including prophylaxis versus rescue treatment and low dose versus high dose therapy have been investigated. The results suggest that intermediate or high doses oral erythromycin used as rescue treatment is associated with a shorter time to attain full enteral feeding, a decrease in the duration of parenteral nutrition requirement, a reduction of parenteral nutrition-associated cholestasis and a decrease in catheter-associated recurrent septicemia. Although none of the studies reported any sinister adverse effects, neonatologists should use this class of drug cautiously and selectively in preterm infants with refractory functional gastrointestinal dysmotility. 

 

Key words: Gastrointestinal dysmotility, enteral feeding, preterm, very low birthweight infants

 

 

 

References

  • Broussand DL. Gastrointestinal motility in the neonate. Clinics in Perinatology 1995; 22: 37-59.
  • Ng PC, Fok TF, Lee CH, et al. Erythromycin treatment for gastrointestinal dysmotility in preterm infants. J Paediatr Child Health 1997; 33: 148-150.
  • Su BH, Lin HC, Peng CT, et al. Efect of erythromycin on feeding intolerance in very low birth weight infants: a preliminary observation. Acta Paediatr Sin 1998; 39: 324-326.
  • Kubota M, Nakamura T, Motokura T, et al. Erythromycin improves gastrointestinal motility in extremely low birth-weight infants. Acta Paediatr Jpn 1994; 36: 198-201.
  • Stenson BJ, Middlemist L, Lyon AJ. Influence of erythromycin on establishment of feeding in preterm infants: observations from a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 1998; 79: F212-F214.
  • Patole SK, Almonte R, Kadalraja R, et al. Can prophylactic oral erythromycin reduce time to full enteral feeds in preterm neonates? Int J Clin Pract 2000; 54: 504-508.
  • Oei J, Lui K. A placebo-controlled trial of lowdose erythromycin to promote feed tolerance in preterm infants. Acta Paediatr 2001; 90: 904-908.
  • El Hennawy AA, Sparks JW, Armentrout D, Huseby V, Berseth CL. Erythromycin fails to improve feeding outcome in feeding-intolerant preterm infants. J Pediatr Gastroenterol Nutr 2003; 37: 281-286.
  • Ng SC, Gomez JM, Rajadurai VS, Saw SM, Quak SH. Establishing enteral feeding in preterm infants with feeding intolerance: a randomized controlled study of low-dose erythromycin. J Pediatr Gastroenterol Nutr 2003; 37: 554-558.
  • Cairns P, Craig S, Tubman R, et al. Randomised controlled trial of low-dose erythromycin in preterm infants with feed intolerance (abstract). Pediatr Res 2002; 51: 379A-380A.
  • Aly H, Abdel-Hady H, Khashaba M, El-Badry N. Erythromycin and feeding intolerance in premature infants: a randomized trial. J Perinatol 2007; 27: 39-43.
  • Nuntnarumit P, Kiatchoosakun P, Tantiprapa W, Boonkasidecha S. Efficacy of oral erythromycin for treatment of feeding intolerance in preterm infants. J Pediatr 2006; 148: 600-605.
  • Ng PC, So KW, Fung KSC, et al. Randomised controlled study of oral erythromycin for treatment of gastrointestinal dysmotility in preterm infants. Arch Dis Child Fetal Neonatal Ed 2001; 84: F177-F182.
  • Ng PC, Lee CH, Wong SPS, et al. High-dose oral erythromycin decreased the incidence of parenteral nutrition-associated cholestasis in preterm infants. Gastroenterology 2007; 132: 1726-1739.
  • Moon K, Hillemeier AC. Fetal and neonatal intestinal motility. In: Polin RA and Fox WW, editors. Fetal and Neonatal Physiology, 2nd Ed: WB Saunders 1998: 1383-1386
  • Szurszewski JH. A migrating electric complex of the canine small intestine. Am J Physiol 1969; 217: 1757-1763.
  • Code CF, Schlegel J. The gastrointestinal interdigestive housekeeper: Motor correlates of the interdigestive myoelectric complex of the dog. In Proceedings of the 4th Symposium on GI motility. Vancouver, Mitchell Press Ltd 1973: 631-634.
  • Sarna SK. Cyclic motor activity; migrating motor complex. Gastroenterology 1985; 89: 894-913.
  • Peeters TL, Vantrappen G, Janssens J. Fasting plasma motilin levels are related to the interdigestive motility complex. Gastroenterology 1980; 79: 716-719.
  • Thor P, Drol R, Konturek SJ, et al. Effect of somatostatin on myoelectric activity of small bowel. Am J Physiol 1978; 235: E247-E254.
  • Hall KE, Diamant NE, El-Sharkway TY, et al. Effect of pancreatic polypeptide on canine migrating motor complex and plasma motilin. Am J of Physiol 1983; 245: G178-G185.
  • Amaranth RP, Berseth CL, Malagelada JR, et al. Postnatal maturation of small intestinal motility in preterm infants. Journal of Gastrointestinal Motility 1989; 1: 138-143.
  • Berseth CL. Gestational evolution of small intestinal motility in preterm and term infants. J Pediatr 1989; 115: 646-651.
  • Hillemeier AC, Bitar KN, Biancani P. Developmental characteristics of kitten antrum. Gastroenterology 1991; 101: 339-343.
  • Al Tawil YS, Jadcharla SR, Berseth CL. Motor activity responses to bolus feeding differ in preterm and term infants. J Pediatr Gastroenterol Nutr 1995; 19: 126.
  • Berseth CL. Gastric motility in the neonate. Clinics in Perinatology 1996; 23: 179-190.
  • Houghton LA, Read NW, Heddle R, et al. Motor activity of the gastric antrum, pylorus and duodenum under fasted conditions and after a liquid meal. Gastroenterology 1988; 94: 1276-1284.
  • Cavel B. Gastric emptying in preterm infants. Acta Pediatr Scand 1979; 68: 725-730.
  • Ittman PI, Amarnath R, Berseth CL. Gestational maturation of antroduodenal motor activity in preterm and term infants. Dig Dis Sci 1992; 37:14-19.
  • McClure RJ, Newell SJ. Randomised controlled trial of trophic feeding and gut motility. Arch Dis Child 1999; 80: F54-F58.
  • Curry JI, Lander TD, Stringer MD. Review article: erythromycin as a prokinetic agent in infants and children. Aliment Pharmacol Ther 2001; 15: 593-603.
  • Itol Z, Nakaya M, Suzuki T. Erythromycin mimics exogenous motilin in gastro-intestinal contractile activity in the dog. Am J Physiol 1984; 247: G688-G694.
  • Peeters TL, Ventrappen G, Janssens J. Fasting motilin levels related to the interdigestive motility complex. Gastroenterology 1980; 79: 716-719.
  • Otterson MF, Sarna SK. Gastrointestinal motor effects of erythromycin. Am J Physiol 1990; 259: G355-G63.
  • Mathis C, Malbert CH. Changes in pyloric resistance induced by erythromycin. Neurogastroenterol Motil 1998; 10: 131-138.
  • Peeters TL, Matthijs G, Depoortere I, et al. Erythromycin is a motilin receptor agonist. Am J Physiol 1989; 257: G470-G474.
  • Coulie B, Tack J, Peeters T, et al. Involvement of two different pathways in the motor effects of erythromycin on the gastric antrum in human. Gut 1998; 43: 395-400.
  • Tack J, Janssens J, Vantrappen G, et al. Effect of erythromycin on gastric motility in controls and in diabetic gastroparesis. Gastroenterology 1992;103: 72-79.
  • Annese V, Janssens J, Vantrappen G, et al. Erythromycin accelerates gastric emptying by inducing antral contractions and improved gastroduodenal coordination. Gastroenterology 1992;102: 823-828.
  • Costalos C, Gounaris A, Varhalama E, et al. Erythromycin as a prokinetic agent preterm infants. J Pediatr Gastroenterol Nutr 2002; 34: 23-25.
  • Miller SM, O’Dorisio TM, Thomas FB, et al. Erythromycin exerts a prokinetic effects in patients with chronic idiopathic intestinal pseudoobstruction. Gastroenterology 1990; 98: A375.
  • Pennather A, Tran A, Cioppi M, et al. Erythromycin strengthens the hypotensive lower oesophageal sphincter in patients with gastroesophageal reflux disease. Am J Surg 1994; 167: 169-173.
  • Simkiss DE, Adams IP, Myrdal U, et al. Erythromycin in neonatal postoperative intestinal dysmotility. Arch Dis Child 1994; 71: F128-F129.
  • Jannssens J, Peeters T, Vantrappen G, et al. Improvement of gastric emptying in diabetic gastroparesis by erythromycin. N Engl J Med 1990; 322: 1028-1031.
  • Fiorucci S, Distrutti E, Gerli R, et al. Effect of acute and chronic administration of erythromycin on gastrointestinal motility in scleroma patients. Gastroenterology 1993; 104: A507.
  • Hill AD, Walsh TN, Hamilton D, et al. Erythromycin improves emptying of the denervated stomach after oesophagectomy Br J Surg 1993; 80: 879-881.
  • Patole S, Rao S, Doherty D. Erythromycin as a prokinetic agent in preterm neonates: a systematic review. Arch Dis Child Fetal Neonatal Ed 2005; 90: F301-306.
  • Sørensen HT, Skriver MV, Pedersen L, et al. Risk of infantile hypertrophic pyloric stenosis after maternal postnatal use of macrolides. Scand J Infect Dis 2003; 35: 104-106.
  • Brandriss MW, Richardson WS, Barold SS. Erythromycin-induced QT prolongation and polymorphic ventricular tachycardia: case report and review. Clin Infect Dis 1994; 18: 995-998.
  • Farrar HC, Walsh-Suleys, Kyllonen K, et al. Cardiac toxicity associated with intravenous erythromycin lactobionate : two case reports and a review of the literature. Pediatr Infect Dis J 1993; 12: 688-691.
  • Nogami K, Nishikubo T, Minowan H, et al. Intravenous low-dose erythromycin administration for infants with feeding intolerance. Pediatics International 2001; 43: 605-610.
Year 2010, Volume: 15 Issue: 4, 146 - 150, 17.01.2013

Abstract

References

  • Broussand DL. Gastrointestinal motility in the neonate. Clinics in Perinatology 1995; 22: 37-59.
  • Ng PC, Fok TF, Lee CH, et al. Erythromycin treatment for gastrointestinal dysmotility in preterm infants. J Paediatr Child Health 1997; 33: 148-150.
  • Su BH, Lin HC, Peng CT, et al. Efect of erythromycin on feeding intolerance in very low birth weight infants: a preliminary observation. Acta Paediatr Sin 1998; 39: 324-326.
  • Kubota M, Nakamura T, Motokura T, et al. Erythromycin improves gastrointestinal motility in extremely low birth-weight infants. Acta Paediatr Jpn 1994; 36: 198-201.
  • Stenson BJ, Middlemist L, Lyon AJ. Influence of erythromycin on establishment of feeding in preterm infants: observations from a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 1998; 79: F212-F214.
  • Patole SK, Almonte R, Kadalraja R, et al. Can prophylactic oral erythromycin reduce time to full enteral feeds in preterm neonates? Int J Clin Pract 2000; 54: 504-508.
  • Oei J, Lui K. A placebo-controlled trial of lowdose erythromycin to promote feed tolerance in preterm infants. Acta Paediatr 2001; 90: 904-908.
  • El Hennawy AA, Sparks JW, Armentrout D, Huseby V, Berseth CL. Erythromycin fails to improve feeding outcome in feeding-intolerant preterm infants. J Pediatr Gastroenterol Nutr 2003; 37: 281-286.
  • Ng SC, Gomez JM, Rajadurai VS, Saw SM, Quak SH. Establishing enteral feeding in preterm infants with feeding intolerance: a randomized controlled study of low-dose erythromycin. J Pediatr Gastroenterol Nutr 2003; 37: 554-558.
  • Cairns P, Craig S, Tubman R, et al. Randomised controlled trial of low-dose erythromycin in preterm infants with feed intolerance (abstract). Pediatr Res 2002; 51: 379A-380A.
  • Aly H, Abdel-Hady H, Khashaba M, El-Badry N. Erythromycin and feeding intolerance in premature infants: a randomized trial. J Perinatol 2007; 27: 39-43.
  • Nuntnarumit P, Kiatchoosakun P, Tantiprapa W, Boonkasidecha S. Efficacy of oral erythromycin for treatment of feeding intolerance in preterm infants. J Pediatr 2006; 148: 600-605.
  • Ng PC, So KW, Fung KSC, et al. Randomised controlled study of oral erythromycin for treatment of gastrointestinal dysmotility in preterm infants. Arch Dis Child Fetal Neonatal Ed 2001; 84: F177-F182.
  • Ng PC, Lee CH, Wong SPS, et al. High-dose oral erythromycin decreased the incidence of parenteral nutrition-associated cholestasis in preterm infants. Gastroenterology 2007; 132: 1726-1739.
  • Moon K, Hillemeier AC. Fetal and neonatal intestinal motility. In: Polin RA and Fox WW, editors. Fetal and Neonatal Physiology, 2nd Ed: WB Saunders 1998: 1383-1386
  • Szurszewski JH. A migrating electric complex of the canine small intestine. Am J Physiol 1969; 217: 1757-1763.
  • Code CF, Schlegel J. The gastrointestinal interdigestive housekeeper: Motor correlates of the interdigestive myoelectric complex of the dog. In Proceedings of the 4th Symposium on GI motility. Vancouver, Mitchell Press Ltd 1973: 631-634.
  • Sarna SK. Cyclic motor activity; migrating motor complex. Gastroenterology 1985; 89: 894-913.
  • Peeters TL, Vantrappen G, Janssens J. Fasting plasma motilin levels are related to the interdigestive motility complex. Gastroenterology 1980; 79: 716-719.
  • Thor P, Drol R, Konturek SJ, et al. Effect of somatostatin on myoelectric activity of small bowel. Am J Physiol 1978; 235: E247-E254.
  • Hall KE, Diamant NE, El-Sharkway TY, et al. Effect of pancreatic polypeptide on canine migrating motor complex and plasma motilin. Am J of Physiol 1983; 245: G178-G185.
  • Amaranth RP, Berseth CL, Malagelada JR, et al. Postnatal maturation of small intestinal motility in preterm infants. Journal of Gastrointestinal Motility 1989; 1: 138-143.
  • Berseth CL. Gestational evolution of small intestinal motility in preterm and term infants. J Pediatr 1989; 115: 646-651.
  • Hillemeier AC, Bitar KN, Biancani P. Developmental characteristics of kitten antrum. Gastroenterology 1991; 101: 339-343.
  • Al Tawil YS, Jadcharla SR, Berseth CL. Motor activity responses to bolus feeding differ in preterm and term infants. J Pediatr Gastroenterol Nutr 1995; 19: 126.
  • Berseth CL. Gastric motility in the neonate. Clinics in Perinatology 1996; 23: 179-190.
  • Houghton LA, Read NW, Heddle R, et al. Motor activity of the gastric antrum, pylorus and duodenum under fasted conditions and after a liquid meal. Gastroenterology 1988; 94: 1276-1284.
  • Cavel B. Gastric emptying in preterm infants. Acta Pediatr Scand 1979; 68: 725-730.
  • Ittman PI, Amarnath R, Berseth CL. Gestational maturation of antroduodenal motor activity in preterm and term infants. Dig Dis Sci 1992; 37:14-19.
  • McClure RJ, Newell SJ. Randomised controlled trial of trophic feeding and gut motility. Arch Dis Child 1999; 80: F54-F58.
  • Curry JI, Lander TD, Stringer MD. Review article: erythromycin as a prokinetic agent in infants and children. Aliment Pharmacol Ther 2001; 15: 593-603.
  • Itol Z, Nakaya M, Suzuki T. Erythromycin mimics exogenous motilin in gastro-intestinal contractile activity in the dog. Am J Physiol 1984; 247: G688-G694.
  • Peeters TL, Ventrappen G, Janssens J. Fasting motilin levels related to the interdigestive motility complex. Gastroenterology 1980; 79: 716-719.
  • Otterson MF, Sarna SK. Gastrointestinal motor effects of erythromycin. Am J Physiol 1990; 259: G355-G63.
  • Mathis C, Malbert CH. Changes in pyloric resistance induced by erythromycin. Neurogastroenterol Motil 1998; 10: 131-138.
  • Peeters TL, Matthijs G, Depoortere I, et al. Erythromycin is a motilin receptor agonist. Am J Physiol 1989; 257: G470-G474.
  • Coulie B, Tack J, Peeters T, et al. Involvement of two different pathways in the motor effects of erythromycin on the gastric antrum in human. Gut 1998; 43: 395-400.
  • Tack J, Janssens J, Vantrappen G, et al. Effect of erythromycin on gastric motility in controls and in diabetic gastroparesis. Gastroenterology 1992;103: 72-79.
  • Annese V, Janssens J, Vantrappen G, et al. Erythromycin accelerates gastric emptying by inducing antral contractions and improved gastroduodenal coordination. Gastroenterology 1992;102: 823-828.
  • Costalos C, Gounaris A, Varhalama E, et al. Erythromycin as a prokinetic agent preterm infants. J Pediatr Gastroenterol Nutr 2002; 34: 23-25.
  • Miller SM, O’Dorisio TM, Thomas FB, et al. Erythromycin exerts a prokinetic effects in patients with chronic idiopathic intestinal pseudoobstruction. Gastroenterology 1990; 98: A375.
  • Pennather A, Tran A, Cioppi M, et al. Erythromycin strengthens the hypotensive lower oesophageal sphincter in patients with gastroesophageal reflux disease. Am J Surg 1994; 167: 169-173.
  • Simkiss DE, Adams IP, Myrdal U, et al. Erythromycin in neonatal postoperative intestinal dysmotility. Arch Dis Child 1994; 71: F128-F129.
  • Jannssens J, Peeters T, Vantrappen G, et al. Improvement of gastric emptying in diabetic gastroparesis by erythromycin. N Engl J Med 1990; 322: 1028-1031.
  • Fiorucci S, Distrutti E, Gerli R, et al. Effect of acute and chronic administration of erythromycin on gastrointestinal motility in scleroma patients. Gastroenterology 1993; 104: A507.
  • Hill AD, Walsh TN, Hamilton D, et al. Erythromycin improves emptying of the denervated stomach after oesophagectomy Br J Surg 1993; 80: 879-881.
  • Patole S, Rao S, Doherty D. Erythromycin as a prokinetic agent in preterm neonates: a systematic review. Arch Dis Child Fetal Neonatal Ed 2005; 90: F301-306.
  • Sørensen HT, Skriver MV, Pedersen L, et al. Risk of infantile hypertrophic pyloric stenosis after maternal postnatal use of macrolides. Scand J Infect Dis 2003; 35: 104-106.
  • Brandriss MW, Richardson WS, Barold SS. Erythromycin-induced QT prolongation and polymorphic ventricular tachycardia: case report and review. Clin Infect Dis 1994; 18: 995-998.
  • Farrar HC, Walsh-Suleys, Kyllonen K, et al. Cardiac toxicity associated with intravenous erythromycin lactobionate : two case reports and a review of the literature. Pediatr Infect Dis J 1993; 12: 688-691.
  • Nogami K, Nishikubo T, Minowan H, et al. Intravenous low-dose erythromycin administration for infants with feeding intolerance. Pediatics International 2001; 43: 605-610.
There are 51 citations in total.

Details

Primary Language English
Journal Section Letter to the Editor
Authors

King Woon So This is me

Pak Cheung Ng This is me

Publication Date January 17, 2013
Published in Issue Year 2010 Volume: 15 Issue: 4

Cite

APA So, K. W., & Ng, P. C. (2013). Erythromycin and gastrointestinal dysmotility in preterm infants. EASTERN JOURNAL OF MEDICINE, 15(4), 146-150.
AMA So KW, Ng PC. Erythromycin and gastrointestinal dysmotility in preterm infants. EASTERN JOURNAL OF MEDICINE. March 2013;15(4):146-150.
Chicago So, King Woon, and Pak Cheung Ng. “Erythromycin and Gastrointestinal Dysmotility in Preterm Infants”. EASTERN JOURNAL OF MEDICINE 15, no. 4 (March 2013): 146-50.
EndNote So KW, Ng PC (March 1, 2013) Erythromycin and gastrointestinal dysmotility in preterm infants. EASTERN JOURNAL OF MEDICINE 15 4 146–150.
IEEE K. W. So and P. C. Ng, “Erythromycin and gastrointestinal dysmotility in preterm infants”, EASTERN JOURNAL OF MEDICINE, vol. 15, no. 4, pp. 146–150, 2013.
ISNAD So, King Woon - Ng, Pak Cheung. “Erythromycin and Gastrointestinal Dysmotility in Preterm Infants”. EASTERN JOURNAL OF MEDICINE 15/4 (March 2013), 146-150.
JAMA So KW, Ng PC. Erythromycin and gastrointestinal dysmotility in preterm infants. EASTERN JOURNAL OF MEDICINE. 2013;15:146–150.
MLA So, King Woon and Pak Cheung Ng. “Erythromycin and Gastrointestinal Dysmotility in Preterm Infants”. EASTERN JOURNAL OF MEDICINE, vol. 15, no. 4, 2013, pp. 146-50.
Vancouver So KW, Ng PC. Erythromycin and gastrointestinal dysmotility in preterm infants. EASTERN JOURNAL OF MEDICINE. 2013;15(4):146-50.