Clarithromycin treatment in preterm infants: a pilot study for prevention of feeding intolerance.

ABSTRACT

OBJECTIVE: To compare the effectiveness of oral clarithromycin versus placebo treatment in preventing feeding intolerance in very low birth weight (VLBW) infants. STUDY DESIGN: A prospective, randomised controlled trial in which two groups of preterm infants (birth weight <1500 g) were randomised to clarithromycin (7.5 mg/kg/dose every 12 h) or placebo treatment. During the period, 38 infants, whose parents accepted participation, were enrolled in the study. Feeding intolerance and time to achieve full enteral feeding were considered as primary outcome measures. RESULTS: Feeding intolerance was significantly longer in placebo than clarithromycin (p = 0.031). Time to achieve full feeding after beginning the treatment was equal among the groups. CONCLUSION: This is the first randomised controlled study of clarithromycin and placebo treatment that compares the improvement of feeding intolerance in VLBW infants. Our findings indicate a dramatic improvement in feeding intolerance after oral clarithromycin treatment. But according to our results, clarithromycin-treated infants were not able to attain full enteral feeding more quickly than placebo. This may be due to prophylactic usage of clarithromycin. Significant differences might have resulted if only infants who had feeding intolerance were recruited.