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Use and Safety of Erythromycin and Metoclopramide in Hospitalized Infants.

Publication ,  Journal Article
Ericson, JE; Arnold, C; Cheeseman, J; Cho, J; Kaneko, S; Wilson, E; Clark, RH; Benjamin, DK; Chu, V; Smith, PB; Hornik, CP ...
Published in: J Pediatr Gastroenterol Nutr
September 2015

OBJECTIVE: Prokinetic medications are used in premature infants to promote motility and decrease time to full enteral feeding. Erythromycin and metoclopramide are the most commonly used prokinetic medications in the neonatal intensive care unit (NICU), but their safety profile is not well defined. METHODS: We conducted a large retrospective cohort study using data from 348 NICUs managed by the Pediatrix Medical Group. All of the infants exposed to ≥1 dose of erythromycin, metoclopramide, or both, from a cohort of 8,87,910 infants discharged between 1997 and 2012 were included. We collected laboratory and clinical information while infants were exposed to erythromycin or metoclopramide and described the frequency of laboratory abnormalities and clinical adverse events (AEs). RESULTS: Metoclopramide use increased from 1997 to 2005 and decreased from 2005 to 2012, whereas erythromycin use remained stable. Erythromycin use was most often associated with a diagnosis of feeding problem (40%), whereas metoclopramide was most often associated with a diagnosis of gastroesophageal reflux (59%). The most common laboratory AE during exposure to erythromycin or metoclopramide was hyperkalemia (8.6/1000 infant days on erythromycin and 11.0/1000 infant days on metoclopramide). Incidence of pyloric stenosis was greater with erythromycin than with metoclopramide (10/1095, 0.9% vs 76/19,001, 0.4%; P = 0.01), but odds were not significantly increased after adjusting for covariates (odds ratio 0.52, 95% confidence interval [CI] 0.26-1.02, P = 0.06). More infants experienced an AE while treated with metoclopramide than with erythromycin (odds ratio 1.21, 95% CI 1.03-1.43). CONCLUSIONS: Metoclopramide was associated with increased risk of AEs compared with erythromycin. Studies are needed to confirm safety and effectiveness of both the drugs in infants.

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Published In

J Pediatr Gastroenterol Nutr

DOI

EISSN

1536-4801

Publication Date

September 2015

Volume

61

Issue

3

Start / End Page

334 / 339

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Pyloric Stenosis, Hypertrophic
  • Metoclopramide
  • Male
  • Intensive Care Units, Neonatal
  • Infant, Premature, Diseases
  • Infant, Premature
  • Infant, Newborn
  • Incidence
  • Hyperkalemia
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Ericson, J. E., Arnold, C., Cheeseman, J., Cho, J., Kaneko, S., Wilson, E., … Best Pharmaceuticals for Children Act–Pediatric Trials Network Administrative Core Committee, . (2015). Use and Safety of Erythromycin and Metoclopramide in Hospitalized Infants. J Pediatr Gastroenterol Nutr, 61(3), 334–339. https://doi.org/10.1097/MPG.0000000000000792
Ericson, Jessica E., Christopher Arnold, Jomani Cheeseman, Jordan Cho, Sarah Kaneko, Ele’na Wilson, Reese H. Clark, et al. “Use and Safety of Erythromycin and Metoclopramide in Hospitalized Infants.J Pediatr Gastroenterol Nutr 61, no. 3 (September 2015): 334–39. https://doi.org/10.1097/MPG.0000000000000792.
Ericson JE, Arnold C, Cheeseman J, Cho J, Kaneko S, Wilson E, et al. Use and Safety of Erythromycin and Metoclopramide in Hospitalized Infants. J Pediatr Gastroenterol Nutr. 2015 Sep;61(3):334–9.
Ericson, Jessica E., et al. “Use and Safety of Erythromycin and Metoclopramide in Hospitalized Infants.J Pediatr Gastroenterol Nutr, vol. 61, no. 3, Sept. 2015, pp. 334–39. Pubmed, doi:10.1097/MPG.0000000000000792.
Ericson JE, Arnold C, Cheeseman J, Cho J, Kaneko S, Wilson E, Clark RH, Benjamin DK, Chu V, Smith PB, Hornik CP, Best Pharmaceuticals for Children Act–Pediatric Trials Network Administrative Core Committee. Use and Safety of Erythromycin and Metoclopramide in Hospitalized Infants. J Pediatr Gastroenterol Nutr. 2015 Sep;61(3):334–339.

Published In

J Pediatr Gastroenterol Nutr

DOI

EISSN

1536-4801

Publication Date

September 2015

Volume

61

Issue

3

Start / End Page

334 / 339

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Pyloric Stenosis, Hypertrophic
  • Metoclopramide
  • Male
  • Intensive Care Units, Neonatal
  • Infant, Premature, Diseases
  • Infant, Premature
  • Infant, Newborn
  • Incidence
  • Hyperkalemia