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The use of erythromycin in newborns is a risk factor for the development of hypertrophic pyloric stenosis

The objective of the study, led by American scientists, was to assess the risk of hypertrophic pyloric stenosis (GP) in children who have been systematically prescribed erythromycin, eye ointments to erythromycin and in children whose mothers received macrolides during pregnancy.

A retrospective cohort study involved 14,876 children born at the Indianapolis hospital between June 1993 and December 1999.

It turned out that out of 14,876 children, 43 (0.29%) were diagnosed with hypertrophic pyloric stenosis; erythromycin was prescribed to 469 children. Children who were prescribed systemic erythromycin were at risk for developing hypertrophic pyloric stenosis, with the highest risk of developing GP in newborns prescribed erythromycin in the first 2 weeks of life. Of the 243 children who were prescribed erythromycin after 2 weeks of life, none developed hypertrophic pyloric stenosis.

In addition, when prescribing erythromycin for 14 days or more significantly more often (p less than 0.05), hypertrophic pyloric stenosis develops than when it is prescribed with a course of treatment less than 14 days.

Pyloric stenosis has developed in children aged 1 to 3 months and no case of pyloric stenosis has been diagnosed in children older than 3 months.

Local administration of erythromycin in the form of ophthalmic ointment for conjunctivitis is not a risk factor for hypertrophic pyloric stenosis.

The use of macrolides by the mother before childbirth (especially in the previous 10 weeks) is probably associated with an increased risk of hypertrophic pyloric stenosis, but these data require further study. Systemically, erythromycin can be used in early pregnancy.

According to the researchers, the question of alternative therapy for children with chlamydia infection is important. Azithromycin is not a motilin agonist, but its use is not approved for children under 6 months of age. Scientists recommend using erythromycin to prescribe it with therapeutically effective treatments that would have the shortest duration.