Erythromycin and gastrointestinal dysmotility in preterm infants

Gastrointestinal dysmotility is a common condition in preterm infants due to immature development of gastrointestinal peristalsis. Erythromycin, with its motilinomimetric effect, has been used to facilitate enteral feeding in preterm infants. Various regimens, including prophylaxis versus rescue treatment and low dose versus high dose therapy have been investigated. The results suggest that intermediate or high doses oral erythromycin used as rescue treatment is associated with a shorter time to attain full enteral feeding, a decrease in the duration of parenteral nutrition requirement, a reduction of parenteral nutrition-associated cholestasis and a decrease in catheter-associated recurrent septicemia. Although none of the studies reported any sinister adverse effects, neonatologists should use this class of drug cautiously and selectively in preterm infants with refractory functional gastrointestinal dysmotility.