Oral erythromycin for the prevention and treatment of feeding intolerance in preterm infants-meta analysis of randomized controlled trials

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Author:
ZHANG Zhi-qun(Department of Pediatrics,Hangzhou Hospital Affiliated to Nanjing Medical University,Hangzhou 310006,China)
LI Hui-ping()
HUANG Xian-mei(Department of Pediatrics,Hangzhou Hospital Affiliated to Nanjing Medical University,Hangzhou 310006,China)
ZHU Jian-xing()
Journal Title:
CHINESE JOURNAL OF PERINATAL MEDICINE
Issue:
Volume 13, Issue 03, 2010
DOI:
10.3760/cma.j.issn.1007-9408.2010.03.007
Key Word:
Infant,premature;Erythromycin;Parenteral nutrition,total;Meta-analysis

Abstract: Objective To evaluate the efficacy and safety of oral erythromycin in the prevention and treatment of feeding intolerance in preterm infants. Methods The Cochrane Library,PubMed,EMBASE,CBMdise,VIP,WartFang and CNKl were searched up to the year of 2008.Randomized controlled trials (RCT) of erythmmycin for feeding intolerance in preterm infants were included.According to the dosage (low-dose,3-15 mg/kg and high dose,>15 mg/kg)and gestational age(≤32 weeks vs>32 weeks),all infants were divided into several subgroups.Meta-analysis was performed with the Cochrane Collaboration's software RevMan. Results Nine RCrs involving 542 premature infants were included.(1)In preventive studies,low-dose erythromycin could significantly decrease the duration of total parenteral nutrition compared with the high-dose erythmmycin (WMD=-2.99,95%CI:-3.99--1.98).(2)Intreatment studies,highdose erythromycin could significantly decrease the duration of total parenteral nutrition (WMD=-7.06.95%CI:-7.91--6.20,P<0.01)and hospital stay (WMD=-8.10,95%CI:-14.02--2.18,P=0.007)compared with the placebo when gestational age≤32 weeks. Erythromydn could decrease the incidence of iaundice(RR=0.36,95%CI:0.21-0.63,P=0.0003)which might be the effect of bigh-dose erytromycin. Conclusions Compared with placebo,oral erythromycin of different dosage might help to achieve full enteral feeding,shorten the duration of parenteral nutrition and hospital stay,and reduce the associated cholestasis jaundice of preterm infants with different gestational age respectively.

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