Study Of Erythromycin And Neonatal Feeding Intolerance

Objective To evaluate the efficiency of different erythromycin (EM) administrations on feeding intolerance, investigate the adverse effects of erythromycin, and study the correlative factors associated with neonatal feeding intolerance. Methods 337 cases admitted from February 2004 to December 2004 were observed. The diagnostic criteria of neonatal feeding intolerance established by Huang Ying is a) the frequency of vomiting≥3 times/day; b) enteral feeding did not increase or decrease>3 days; c) gastric residual volumes>1/3 of previous feeding volumes. 36 infants were enrolled in the trial group and randomly assigned in EM-A group (5mg/kg.dose, Qd) or EM-B group (5mg/kg.dose, Q12h). Meanwhile, 36 infants without feeding intolerance were allocated in the control group for a case-control study (paired ratio 1:1). The clinical data such as feeding volumes, calorie intakes, weight, gastric residual volumes (GRV), frequencies of vomiting and stool were recorded daily. And the correlative laboratory examinations were collected and analyzed periodically. Results (1) The incidence rate of feeding intolerance in 337 infants was 11.3%. Statistical difference was significant in different birth weight infants on the incidence rate (χ2=66.766, P<0.01). The incidence rates in term infants were 4.2%, preterm infants BW (birth weight) > 2000g were 29.6%, and BW≤2000g were 52.4% respectively.(2) Feeding volumes, calorie intakes, weight-gaining and stool frequencies increased after treatment while GRV% decreased in both EM-A and EM-B groups. All were significantly different (P<0.01).(3) There were no significant differences between EM-A group and EM-B group on the time when GRV%≤10%, daily calorie intakes reached 50,100kcal/kg.d, birth weight regained and weight-gaining after treatment (P>0.05).(4) Trial group on the time that daily calorie intakes reached 50,80kcal/kg.d was slower than control group. There was significant difference between two groups (P<0.05).(5) The effect rate of treating neonatal feeding intolerance in EM-A group and EM-B group was 66.67% and 44.44% respectively. The total rate was 55.56%. Moreover, there were no statistical differences between them(P>0.05).(6) There were no significant differences before and after treatment in EM-A group and EM-B group on the blood routine, liver function and electrocardiogram change(P>0.05).(7) The protect factor associated with feeding intolerance was birth weight (B=-3.550), but the risk factors were fetal distress (B=2.759) and gastric hemorrhage (B=2.317). Conclusions The incidence of feeding intolerance was different in infants with different birth weight. There was no difference in the effect rate and the main efficiency index of treatment between EM-A group and EM-B group. There was no correlation between different administrations and therapeutic efficacy. No adverse event of EM was found. The factors associated with feeding intolerance were birth weight, fetal distress, and gastric hemorrhage. Erythromycin was effective and safe in treating neonatal feeding intolerance.