Oral erythromycin for treatment of feeding intolerance in very low birth weight preterm infants

journal1 ›› 2012, Vol. 20 ›› Issue (12): 1114-1117.

Previous Articles Next Articles

Oral erythromycin for treatment of feeding intolerance in very low birth weight preterm infants

YANG Yi-lin¹,ZHUANG Si-qi¹,LIU Xiao-hong²,WANG Bin³,ZHU Xiao-yu⁴,CUI Qi-liang⁵,YANG Jie⁶,HE Shao-ru⁷

1 Department of Pathophysiology,First Hospital,SUN Yat-sen University,Guangzhou,Guangdong 510080,China;
2 Department of Newborn,Shenzhen Children's Hospital,Shenzhen,Guangdong 518038,China;
3 Department of Pathophysiology,Zhujiang Hospital,Southern Medical University,Guangzhou,Guangdong 510280,Chian;
4 Department of Newborn,Maternal and Child Health Hospital of Shenzhen,Shenzhen,Guangdong 518048,China;5 Department of Pathophysiology,Third Hospital,Guangzhou Medical University,Guangzhou,Guangdong 510150,China;
6 Department of Newborn,Guangdong Maternal and Children Hospital,Guangzhou,Guangdong 510010,China;
7 Department of Pathophysiology,Guangdong General Hospital,Guangzhou,Guangdong 510080,China

Received:2012-05-02 Online:2012-12-06 Published:2012-12-06

口服红霉素在极低出生体重早产儿喂养不耐受的治疗作用

杨伊琳¹,庄思齐¹,刘晓红²,王斌³,朱小瑜⁴,崔其亮⁵,杨杰⁶,何少茹⁷

1 中山大学附属第一医院儿科,广东广州 510080;
2 深圳市儿童医院新生儿科,广东深圳 518038;
3 南方医科大学附属珠江医院儿科,广东广州 510280;
4 深圳市妇幼保健院新生儿科,广东深圳 518048;
5 广州医学院第三附属医院儿科,广东广州 510150;
6 广东省妇幼保健院新生儿科,广东广州 510010;
7 广东省人民医院儿科,广东广州 510080

通讯作者: 庄思齐,E-mail:suesq @126.com
作者简介:杨伊琳(1982-),女,广东人,住院医师,硕士学位,主要主要研究方向为新生儿疾病

Abstract

Abstract: 【Objective】 A prospective,multi-center,controlled study was performed to evaluate the effectiveness and possible side effects of oral erythromycin (EM) in treating preterm infants,especially VLBW(very low birth-weight )preterm infants with feeding intolerance(FI). 【Methods】 46 preterm infants with FI from 16 hospitals were enrolled,study period from January,2008 to March,2010.The patients were divided into 3 random groups:EM-HD group,oral erythromycin 12.5 mg/kg,q8h for 7~10 days; EM-LD group,oral erythromycin 5 mg/kg,therapy as above; and control group,not treated by any gastrointestinal prokinetic agent.Several critical time points of feeding condition were compared,the incidence of extrauterine growth retardation (EUGR) and the potential adverse effects of erythromycin were also evaluated. 【Results】 11 patients had be classed as EM-HD group,22 as EM-LD group,13 as control.After enrollment,the time reaching 50 kCal/(kg·d) from enteral feeding were significantly shorter and the proportions of calorie ingested by the enteral route when the infants regained to their birth weight were significantly higher in two trial groups than the control group.The incidence of EUGR was significantly lower in EM-HD group.All enrolled infants were followed up from discharge to 6 months' age,no obvious side effect was found in the trial groups. 【Conclusions】 In this research,both doses of oral erythromycin are effective for treating VLBW preterm infants with FI and the high dose is more effective.There are not obvious side effects of oral erythromycin observed.

Key words: erythromycin, very low birth-weight infant, preterm, feeding intolerance

摘要： 【目的】评价口服不同剂量红霉素对早产儿喂养不耐受(feeding intolerance,FI)的治疗效果及可能存在的副作用,尤其对极低出生体重早产儿FI的治疗作用。【方法】选取2008年1月1日-2010年3月31日在16家三甲医院新生儿科住院并诊断为FI的早产儿,随机分为3组:红霉素大剂量组(第8~10日龄起口服红霉素 12.5 mg/kg,q8 h,疗程7~10 d)、红霉素小剂量组(口服红霉素5 mg/kg,给药方法同上)、对照组(完全不用胃肠动力调节药物)。比较各项喂养相关指标、宫外生长迟缓发生率等,并评估药物副作用。【结果】入组极低体重儿46例,大剂量组11例,小剂量组22例,对照组13例。两治疗组肠内热卡达基础热卡的日龄及体重开始增长时肠内热卡比例较对照组明显改善,大剂量组体重宫外生长迟缓发生率较对照组明显降低。所有治疗组患儿随访6个月均未见明显红霉素副作用。【结论】本研究中选取的两种剂量红霉素口服对极低出生体重早产儿FI均有一定治疗作用,大剂量略优于小剂量。所采用的红霉素治疗方案未见明显副作用。

关键词: 红霉素, 极低出生体重儿, 早产, 喂养不耐受

CLC Number:

R722

YANG Yi-lin,ZHUANG Si-qi,LIU Xiao-hong,WANG Bin,ZHU Xiao-yu,CUI Qi-liang,YANG Jie,HE Shao-ru. Oral erythromycin for treatment of feeding intolerance in very low birth weight preterm infants[J]. journal1, 2012, 20(12): 1114-1117.

杨伊琳,庄思齐,刘晓红,王斌,朱小瑜,崔其亮,杨杰,何少茹. 口服红霉素在极低出生体重早产儿喂养不耐受的治疗作用[J]. 中国儿童保健杂志, 2012, 20(12): 1114-1117.

References

[1] Berseth CL.Gastrointestinal motility in the neonate[J].Clin Perinatol,1996,23(2):179-190.
[2] Oei J,Lui K.A placebo-controlled trial of low-dose erythromycin to promote feed tolerance in preterm infants[J].Acta Paediatr,2001,90(8):904-908.
[3] Ng PC,So KW,Fung KS,et al.Randomised controlled study of oral erythromycin for treatment of gastrointestinal dysmotility in preterm infants[J].Arch Dis Child Fetal Neonatal Ed,2001,84(3):177-182.
[4] Ng PC,Lee CH,Wong SP,et al.High-dose oral erythromycin decreased the incidence of parenteral nutrition-associated cholestasis in preterm infants[J].Gastroenterology,2007,132(5):1726-1739.
[5] Elhennawy AA,Sparks JW,Armentrout D,et al.Erythromycin fails to improve feeding outcome in feeding-intolerant preterm infants[J].J Pediatr Gastroenterol Nutr,2003,37(3):281-286.
[6] Ng SC,Gomez JM,Rajadurai VS,et al.Establishing enteral feeding in preterm infants with feeding intolerance:a randomized controlled study of low-dose erythromycin[J].J Pediatr Gastroenterol Nutr,2003,37(5):554-558.
[7] Nuntnarumit P,Kiatchoosakun P,Tantiprapa W,et al.Efficacy of oral erythromycin for treatment of feeding intolerance in preterm infants[J].J Pediatr,2006,148(5):600-605.
[8] Dellagrammaticas HD,Iacovidou N,Megaloyanni E,et al.Effect of low-dose oral erythromycin on gastric aspirates in ventilated neonates less than 32 weeks of gestation.Preliminary results[J].Biol Neonate,2002,81(3):213-216.
[9] Xu L,Depoortere I,Vertongen P,et al.Motilin and erythromycin-A share a common binding site in the third transmembrane segment of the motilin receptor[J].Biochem Pharmacol,2005,70(6):879-887.
[10] Peeters TL.Erythromycin and other macrolides as prokinetic agents[J].Gastroenterology,1993,105(6):1886-1899.
[11] Weber FJ,Richards RD,Mccallum RW.Erythromycin:a motilin agonist and gastrointestinal prokinetic agent[J].Am J Gastroenterol,1993,88(4):485-490.
[12] Coulie B,Tack J,Peeters T,et al.Involvement of two different pathways in the motor effects of erythromycin on the gastric antrum in humans[J].Gut,1998,43(3):395-400.
[13] Gouyon JB,Benoit A,Betremieux P,et al.Cardiac toxicity of intravenous erythromycin lactobionate in preterm infants[J].Pediatr Infect Dis J,1994,13(9):840-841.
[14] Maheshwai N.Are young infants treated with erythromycin at risk for developing hypertrophic pyloric stenosis?[J].Arch Dis Child,2007,92(3):271-273.
[15] Curry JI,Lander TD,Stringer MD.Review article:erythromycin as a prokinetic agent in infants and children[J].Aliment Pharmacol Ther,2001,15(5):595-603.
[16] Westphal JF,Vetter D,Brogard JM.Hepatic side-effects of antibiotics[J].J Antimicrob Chemother,1994,33(3):387-401.

Oral erythromycin for treatment of feeding intolerance in very low birth weight preterm infants

口服红霉素在极低出生体重早产儿喂养不耐受的治疗作用

PDF

Knowledge

Cited

Abstract

Cite this article

share this article

References

Related Articles 15

Recommended Articles

Metrics

[1]	XIE Haixia, LUO Hongxia, LIU Haixia, SHAO Qinnan, FENG Guojun, WEN Yalan. Impact of histological chorioamnioitis on complications and neurodevelopment in premature infants at 1 year of age [J]. Chinese Journal of Child Health Care, 2024, 32(9): 947-952.
[2]	WANG Yinfei, YIN Qin, ZENG Sijie, SUN Lei, YAN Qinhui, SHENG Xiaojing. Differences in exosome miRNAs in human breast milk between preterm and full-term infants [J]. Chinese Journal of Child Health Care, 2024, 32(4): 377-383.
[3]	YU Hanshu, SUN Ruizhen, YANG Yanling, SU Yuehua, FU Zhongying. Effectiveness of extensively hydrolyzed formula in treating feeding intolerance in preterm infants [J]. Chinese Journal of Child Health Care, 2024, 32(4): 456-459.
[4]	CHEN Die, PENG Wentao, TANG Mengyan, LIU Xiaomei. Status quo of preterm infants' feeding difficulties at weaning and self-feeding transition stage and its influencing factors [J]. Chinese Journal of Child Health Care, 2024, 32(1): 21-25.
[5]	NING Yue, LUO Liyan, DUAN Jiang, XIE Yunbo, QI Zhiye, ZHANG Caiying, YANG Li, ZHONG Qinghua. Effects of different fortified feeding methods on the nutrient metabolism and growth rate of very low birth weight preterm infants [J]. Chinese Journal of Child Health Care, 2024, 32(1): 84-88.
[6]	ZHANG Dan, ZHANG Jun, YANG Yurong, CAO Mi, YAN Jingmin, ZHU Luyang. Research advances on the correlation of gut microbiota with brain development and neurocognitive behavior in preterm infants [J]. Chinese Journal of Child Health Care, 2023, 31(7): 756-759.
[7]	FENG Xiao, CHEN Ling, ZHAO Hongying, HUANG Rui, LIN Chenxi, ZHUANG Lijuan. Effects of different ways of umbilical cord milking on the outcome of very preterm infants [J]. Chinese Journal of Child Health Care, 2023, 31(7): 794-798.
[8]	XIA Zhenglong, SONG Yanyan. Research progress in the neurodevelopment of preterm infants with bronchopulmonary dysplasia [J]. Chinese Journal of Child Health Care, 2023, 31(4): 390-394.
[9]	LI Jinglan, SUN Wenqiang, ZHU Xueping. Research progress in the prediction model of bronchopulmonary dysplasia in preterm infants [J]. Chinese Journal of Child Health Care, 2023, 31(4): 395-398.
[10]	REN Li, HEI Mingyan, QI Yujie, JIN Fei, WENG Jingwen, DONG Shixiao, SHEN Yanhua, JIANG Min. Influence of feeding factors on necrotizing enterocolitis in preterm neonates [J]. Chinese Journal of Child Health Care, 2023, 31(4): 438-441.
[11]	CHEN Feng, ZHANG Yu. Retrospective study on the neuropsychological development of preterm multiple births and singleton births [J]. Chinese Journal of Child Health Care, 2023, 31(4): 451-456.
[12]	ZHENG Shuiying, LUO Yanyun. Clinical manifestations and related factors of feeding intolerance in premature infants [J]. Chinese Journal of Child Health Care, 2023, 31(4): 461-464.
[13]	MA Hongfang, XUE Jiang, LIANG Shuang. Protective effect and mechanism of insulin-like growth factor 1 in preterm infants with white matter damage [J]. Chinese Journal of Child Health Care, 2023, 31(11): 1219-1224.
[14]	YOU Fang. Application of individualized vitamin D supplementation in very preterm infants [J]. Chinese Journal of Child Health Care, 2023, 31(10): 1127-1131.
[15]	HE Xiao-ying, WU Cui-ling, ZENG Ling-yan, QI Mei-jiao, SUN Ya-lian. Nutrient biomarkers and their feeding factors for preterm children after introduction of complementary foods [J]. Chinese Journal of Child Health Care, 2023, 31(1): 81-85.