A pioneering study: oral clarithromycin treatment for feeding intolerance in very low birth weight preterm infants.

Purpose: To examine the prokinetic effect of clarithromycin in very low birth weight (VLBW) preterm infants.

Materials And Methods: VLBW preterm infants who have not achieved half of the full enteral feeding in the second week of life were enrolled in the study. The infants enrolled in the study were randomized. Twenty infants received oral clarithromycin (7.5 mg/kg, twice a day) and 20 control infants did not receive any treatment.

Results: Full enteral feeding was attained earlier in the clarithromycin group than in the control group [7 (6-9) versus 9 (9-11) days, respectively; p < .001]. Duration of parenteral nutrition and number of withheld feeds were significantly lower in the clarithromycin group (p = .013 and p < .001, respectively). Parenteral nutrition-associated cholestasis (n = 1 versus 3, p = .1) and length of hospital stay (50 versus 59 median days, p = .1) tend to be lower in the clarithromycin group without any statistical significance. We observed no adverse effect of clarithromycin therapy.

Conclusions: Clarithromycin treatment in VLBW preterm infants resulted in better toleration of enteral feeding. Larger randomized controlled trials are needed to establish routine use of clarithromycin in the treatment of feeding intolerance.