Erythromycin as a Prokinetic Agent in Preterm Infants

Abstract

ABSTRACTBackgroundThe macrolide antibiotic erythromycin is a prokinetic agent that stimulates gastrointestinal motility. The aim of the study was to determine the effect of erythromycin on the gastrointestinal motility of preterm infants.MethodsErythromycin 10 mg/kg, 8 hourly or a placebo, was given orally for 7 days in a double‐blind randomized, crossover study of 20 preterm infants with a median gestational age of 32 weeks (range, 26–34 weeks). Antral contractility was determined by using ultrasonography to measure the decrease in the gastric antral cross‐sectional area after a feed. The whole gut transit time was assessed by timing the transit of carmine red through the gut.ResultsAntral contractility lasted for a shorter period of time during erythromycin treatment than during placebo treatment (mean [standard deviation], 31 minutes [9.9 minutes] vs. 70 minutes [13 minutes];P < 0.01). Whole gut transit time was also shorter during erythromycin treatment (mean, 23.1 hours [12.9 hours] vs. 49.3 hours [29 hours];P < 0.01). All infants tolerated the drug well.ConclusionsOral erythromycin in food‐intolerant preterm infants enhances both antral contractility and whole gut transit time.