Use of prokinetics in the preterm infant

Lam, Hugh Simon; Ng, Pak Cheung

doi:10.1097/mop.0b013e3283431f2a

Cited by 19 publications

(13 citation statements)

References 41 publications

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“…Most studies have shown a benefit with high-dose erythromycin (>10 mg/kg t.i.d. ), 12,15,16 but no significant benefit with low-dose erythromycin, in management of feeding intolerance. 7,17,18 One study found a significant benefit with high-dose erythromycin (12.5 mg/kg q.i.d) compared to placebo for treating feeding intolerance in preterm infants with birth weight <1,500 grams [13.5 (8-22) vs. 25 (16-33) days, respectively].…”

Section: Discussionmentioning

confidence: 99%

“…But the motilin receptor in smooth muscle can only be stimulated by high-dose erythromycin. 6,12,13 The MMC is immature before 32 weeks of gestation.…”

Section: Discussionmentioning

confidence: 99%

“…He also found no infection or necrotizing enterocolitis outbreaks during the 69-month study. 12 We did not examine our subjects' intestinal microorganisms before or after erythromycin.…”

Section: Discussionmentioning

confidence: 99%

“…Two types of motilin receptors (neural and smooth muscle) have been found and the efficacy of erythromycin depends on the dose and gestational age. 6,12 Low-dose erythromycin (1-3 mg/kg) can stimulate neural motilin receptor (cholinergic nerves of the gut at both preganglionic and postganglionic levels) and induce phase III of MMC. But the motilin receptor in smooth muscle can only be stimulated by high-dose erythromycin.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 This process is not achieved until 32 weeks of gestational age. 9,10 Some studies in infants with intestinal dismotility showed benefits from erythromycin, 9,11,12 while others gave inconsistent results. 13,14 We aimed to assess the efficacy of highdose erythromycin (12.5 mg/kg) as prophylactic management to enhance feeding tolerance in preterm infants, compared to a placebo.…”

mentioning

confidence: 99%

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Efficacy of oral erythromycin to enhance feeding tolerance in preterm infants

Sukmawati

Rohsiswatmo

Suradi

et al. 2017

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Background Feeding intolerance is a common condition that affects preterm infants. Erythromycin is a prokinetic agent used to treat feeding intolerance, but its efficacy remains inconclusive. Objective To evaluate the effectiveness of oral erythromycin to enhance feeding tolerance in preterm infants. Methods This prospective, randomized controlled trial in preterm infants was conducted at Sanglah Hospital, Denpasar, Bali, from June 2015 to January 2016. Eligible infants were randomized to receive either 12.5 mg/kg/dose oral erythromycin or a placebo, every 8 hours. The primary outcome was the time to establish full enteral feeding. The secondary outcomes were body weight at full enteral feeding and length of hospital stay. Results Of 62 initial subjects, 3 infants dropped out of the study. Thirty infants were given erythromycin and 29 infants were given placebo. The baseline characteristics of the two groups were similar, with mean of gestational ages of 31.4 (SD 1.7) weeks in the erythromycin group and 32.4 (SD 2.2) weeks in the placebo group. The median times to reach full enteral feeding did not significantly differ between the two groups, with 10 (SD 5.3) days in the erythromycin group vs. 8 (SD 6.5) days in the placebo group (P=0.345). Also, median body weights at full enteral feeding and lengths of hospital stay were not significantly different between the two groups. Conclusion Erythromycin of 12.5 mg/kg/dose every 8 hours as prophylactic treatment does not significantly enhance feeding tolerance in preterm infants. Median body weights at full enteral feeding and length of hospital stay are not significantly different between the erythromycin and placebo groups. [Paediatr Indones. 2017;57:154-9 doi: http://dx

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Section: Discussionmentioning

confidence: 99%

“…But the motilin receptor in smooth muscle can only be stimulated by high-dose erythromycin. 6,12,13 The MMC is immature before 32 weeks of gestation.…”

Section: Discussionmentioning

confidence: 99%

“…He also found no infection or necrotizing enterocolitis outbreaks during the 69-month study. 12 We did not examine our subjects' intestinal microorganisms before or after erythromycin.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%