The Efficacy of Oral Erythromycin in Enhancement of Milk Tolerance in Premature Infants: A Randomized Clinical Trial

Background:  A great number of premature neonates do not tolerate sufficient milk during the early neonatal period. Objective: To evaluate the effect of oral erythromycin on enhancement of feeding tolerance in preterm newborns. Methods: Sixty preterm neonates intolerant to milk of >75 ml/kg/day during 5 days after the start of feedings, were randomized into a treatment and a control groups.  Oral erythromycin (12.5 mg/kg/dose) was given to the treatment group for a maximum of 10 days, or until full enteral feeding (150 ml/kg/day) was tolerated. Results: Oral erythromycin enhanced feeding tolerance in premature neonates of ≥32 wks of gestation (p<0.032) with no adverse effects and led to a shorter hospital stay (p<0.003) as compared to the control group. Conclusion:  Oral erythromycin is an effective drug for alleviating feeding intolerance in preterms.