Randomized Controlled Trial of a High Dose of Oral Erythromycin for the Treatment of Feeding Intolerance in Preterm Infants

Abstract

Objectives: To evaluate the effectiveness of high-dose erythromycin to treat feeding intolerance in preterm infants predominantly fed milk formula. Design: This study is a prospective randomized controlled trial on 60 premature infants suffering from feeding intolerance. Thirty infants were given oral erythromycin ethylsuccinate at a dose of 50 mg/kg/day for 10 days or until they reached full enteral feeds. Randomization was stratified according to gestational age <32 weeks or ≧32 weeks gestation. The primary end point was the time taken to establish full enteral feeding since enrollment. Potential adverse effects associated with erythromycin were also monitored. Student’s t test was used for comparison of continuous variables and χ²for categorical data. Results: In infants <32 weeks, the use of erythromycin was associated with more daily weight gain (12.8 ± 2.6 g vs. 9.2 ± 5.3 g, p = 0.04) compared to the control group. Time to reach full feed did not differ between the erythromycin (13.8 ± 3.9 days) and the control (17.46 ± 4.9 days) groups (p = 0.07). In infants ≧32 weeks, there were no differences between the erythromycin and the control groups. Conclusion: High-dose erythromycin is associated with greater weight gain in preterm infants <32 weeks gestational age, who are predominantly fed cow’s milk-based protein formulas.