Does carboxymethylcellulose have a role in reducing time to full enteral feeds in preterm neonates?

Patole, Sanjay; Müller, Reinhold

doi:10.1111/j.1742-1241.2004.00353.x

Cited by 26 publications

(49 citation statements)

References 22 publications

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“…Of the 3 prophylactic RCTs ( table 1 ) [10][11][12] , 2 studies did not demonstrate any benefit of erythromycin as an effective prokinetic agent [10,11] . In addition, the objective of the RCT by Stenson et al [10] primarily concerned the use of intravenous erythromycin for eradication of Ureaplasma urealyticum and prevention of chronic lung disease.…”

Section: Review Of Rctsmentioning

confidence: 99%

“…To date, 10 RCTs have reported effects of erythromycin on preterm newborns [10][11][12][13][14][15][16][17][18][19] . Seven RCTs used erythromycin as a rescue treatment [13][14][15][16][17][18][19] and 3 studies used the medication as a prophylactic prokinetic agent [10][11][12] . The characteristics of the study populations and findings of these RCTs are summarized in tables 1 and 2 .…”

Section: Review Of Rctsmentioning

confidence: 99%

“…Further, erythromycin has been used successfully in facilitating transpyloric passage of endoscopes, Watson's capsules and nasoenteric feeding tubes into the proximal small bowel [9] . Although the role of erythromycin as a prokinetic agent in preterm, VLBW infants has been recently investigated in a number of randomized control trials (RCTs) [10][11][12][13][14][15][16][17][18][19] , much controversy concerning its efficacy in promoting enteral feeding and adverse effects remain. This review summarizes the results of recent RCTs in order to explore whether collectively, a common message may emerge so that indications for erythromycin usage and practical guidelines for this medication may be established and gauged according to the prevailing evidence.…”

Section: Introductionmentioning

confidence: 99%

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Use of Oral Erythromycin for the Treatment of Gastrointestinal Dysmotility in Preterm Infants

2008

Neonatology

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Milk intolerance due to functional gastrointestinal (GI) dysmotility is a common problem in preterm infants. In the past decade, erythromycin has been used for its motilinomimetric effect to facilitate enteral feeding in preterm infants. Although earlier studies suggested that erythromycin is an effective prokinetic agent, recent randomized control trials (RCTs) reveal conflicting findings. This review assesses the evidence from all RCTs performed to date on erythromycin for preterm infants. The results suggest that oral erythromycin administered in intermediate or high doses as a rescue treatment is associated with a shorter time to attain full enteral feeding and decrease in the duration of requirement for parenteral nutrition. More importantly, the outcome study further indicates that oral erythromycin can reduce the incidence of parenteral nutrition-associated cholestasis by almost 50% and decreases the incidence of recurrent septicemia. None of the RCTs reported any sinister adverse effects, in particular, hypertrophic infantile pyloric stenosis or fatal cardiac arrhythmia. Nonetheless, as long-term outcomes have not been fully evaluated, neonatologists should use this treatment cautiously and selectively in preterm infants with moderately severe GI dysmotility.

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Section: Review Of Rctsmentioning

confidence: 99%

Section: Review Of Rctsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of Oral Erythromycin for the Treatment of Gastrointestinal Dysmotility in Preterm Infants

2008

Neonatology

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“…It has been shown that 0.75 mg of intravenous erythromycin significantly increased antral motility of the stomach in neonates less than 30 weeks of gestation [1], thus showing functioning motilin receptors. Previous randomised controlled trials using antimicrobial doses (12 mg/kg/6-8-hourly) of erythromycin have failed to demonstrate a beneficial effect on the establishment of full feeds in preterm neonates [7][8][9]. On the other hand in a small study [10] again using antimicrobial doses, a beneficial effect on gastrointestinal dysmotility was observed in 7 preterm infants.…”

Section: Discussionmentioning

confidence: 88%

Effect of Low-Dose Oral Erythromycin on Gastric Aspirates in Ventilated Neonates Less than 32 Weeks of Gestation

Dellagrammaticas¹,

Iacovidou²,

Megaloyanni³

et al. 2002

Neonatology

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In this prospective study, the 24-hour gastric aspirate volume was carefully recorded before, 24 and 48 h after administering 1.7 mg/kg/8-hourly of oral erythromycin to 16 ventilated neonates less than 32 weeks of gestation. Their median gestational age was 28.5 weeks (range 23–31 weeks), their median birthweight was 1,045 g (range 690–1,560 g) and the median day of life at which erythromycin was commenced was 9.5 days (range 4–16 days). Prior to administering erythromycin median 24-hour gastric aspirate volume, expressed as a percentage of the milk volume given over the same period, was 38.5% (range 20.0–100%). It was significantly lower 24 h (median 12%, range 0–41%, p = 0.0004) and 48 h (median 5%, range 0–21%, p = 0.0004) after commencing erythromycin. There was also significant reduction of gastric aspirate volume between 24 and 48 h after commencing erythromycin (p = 0.0024). Milk volume increment over the same period was not significant (p = 0.1022). These preliminary results warrant further evaluation through a randomised controlled trial.

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“…A number of studies carried out to investigate the prokinetic action of erythromycin in children (7) have obtained considerable evidence that the drug may be a useful prokinetic agent in feeding intolerance associated with prematurity, in low birth weight infants recovering from abdominal surgery, and in older children with a variety of other gastrointestinal disorders (8)(9)(10)(11). Only one randomized placebo-controlled trial has been conducted (12) and there are no clinical studies on the use of erythromycin in children with constipation.…”

mentioning

confidence: 99%

Use of erythromycin for the treatment of severe chronic constipation in children

Bellomo-Brandão

Collares

Da-Costa-Pinto

2003

Braz J Med Biol Res

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The efficacy of erythromycin was assessed in the treatment of 14 children aged 4 to 13 years with refractory chronic constipation, and presenting megarectum and fecal impaction. A double-blind, placebocontrolled, crossover study was conducted at the Pediatric Gastroenterology Outpatient Clinic of the University Hospital. The patients were randomized to receive placebo for 4 weeks followed by erythromycin estolate, 20 mg kg -1 day -1 , divided into four oral doses for another 4 weeks, or vice versa. Patient outcome was assessed according to a clinical score from 12 (most severe clinical condition) to 0 (complete recovery). At enrollment in the study and on the occasion of follow-up medical visits at two-week intervals, patient score and laxative requirements were recorded. During the first 30 days, the mean ± SD clinical score for the erythromycin group (N = 6) decreased from 8.2 ± 2.3 to 2.2 ± 1.0 while the score for the placebo group (N = 8) decreased from 7.8 ± 2.1 to 2.9 ± 2.8. During the second crossover phase, the score for patients on erythromycin ranged from 2.9 ± 2.8 to 2.4 ± 2.1 and the score for the patients on placebo worsened from 2.2 ± 1.0 to 4.3 ± 2.3. There was a significant improvement in score when patients were on erythromycin (P < 0.01). Mean laxative requirement was lower when patients ingested erythromycin (P < 0.05). No erythromycin-related side effects occurred. Erythromycin was useful in this group of severely constipated children. A larger trial is needed to fully ascertain the prokinetic efficacy of this drug as an adjunct in the treatment of severe constipation in children. Correspondence

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Does carboxymethylcellulose have a role in reducing time to full enteral feeds in preterm neonates?

Cited by 26 publications

References 22 publications

Use of Oral Erythromycin for the Treatment of Gastrointestinal Dysmotility in Preterm Infants

Use of Oral Erythromycin for the Treatment of Gastrointestinal Dysmotility in Preterm Infants

Effect of Low-Dose Oral Erythromycin on Gastric Aspirates in Ventilated Neonates Less than 32 Weeks of Gestation

Use of erythromycin for the treatment of severe chronic constipation in children

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