Clinical Use of Erythromycin in Children with Gastrointestinal Dysmotility

PRAPUN AANPREUNG, M.D.*, CHIRASRI V AJARADUL, M.D.*

Affiliation : *Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

AbstractIntolerant feeding is a common symptom in gastrointestinal disorders which is commonly found in systemic diseases. Prokinetic drugs play a role in management. A low dose of erythro mycin has an effect on improvement of antroduodenal motility and gastric emptying in children and adults. The objective of this study was to evaluate the efficacy of intravenous erythromycin in the treatment of GI dysmotility in children.
Retrospective studies were performed in the Department of Pediatrics, Siriraj Hospital, Mahidol University between 1996 and 2000 in 22 patients with intolerance of feeding due to GI dysmotility. Their ages ranged from 11 days to 12 years (42.1 ± 48.1 months). The patients were divided into 2 groups : 12 critically ill and 10 non-critically ill patients. Dosages of intravenous erythromycin were 1-3 mg/kg/dose every 6 hours. The result of treatment was evaluated as : good (tolerant feeding), fair (tolerant feeding but needing erythromycin for longer than I month) and failed (intolerant feeding).
All non-critically ill patients had improved symptoms with 9 ± 4.3 days duration of treat ment. In the other group, 8 patients had good results with 10.9 ± 6 days of treatment. Two patients needed the drug for longer than 1 month and the other 2 patients did not respond and died due to severe infection. Low dose intravenous erythromycin had good efficacy in the treatment of intolerant feeding related to GI dysmotility in children.

Keywords : Erythromycin, GI Dysmotility, Gastroparesis, Paralytic Ileus, Critically Ill, Tube Feeding

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