PMID- 25806675
OWN - NLM
STAT- MEDLINE
DCOM- 20160526
LR  - 20240407
IS  - 1536-4801 (Electronic)
IS  - 0277-2116 (Print)
IS  - 0277-2116 (Linking)
VI  - 61
IP  - 3
DP  - 2015 Sep
TI  - Use and Safety of Erythromycin and Metoclopramide in Hospitalized Infants.
PG  - 334-9
LID - 10.1097/MPG.0000000000000792 [doi]
AB  - 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.
FAU - Ericson, Jessica E
AU  - Ericson JE
AD  - *Duke Clinical Research Institute daggerDepartment of Medicine, Duke University, 
      Durham, NC double daggerPediatrix-Obstetrix Center for Research and Education, Sunrise, FL.
FAU - Arnold, Christopher
AU  - Arnold C
FAU - Cheeseman, Jomani
AU  - Cheeseman J
FAU - Cho, Jordan
AU  - Cho J
FAU - Kaneko, Sarah
AU  - Kaneko S
FAU - Wilson, Ele'na
AU  - Wilson E
FAU - Clark, Reese H
AU  - Clark RH
FAU - Benjamin, Daniel K Jr
AU  - Benjamin DK Jr
FAU - Chu, Vivian
AU  - Chu V
FAU - Smith, P Brian
AU  - Smith PB
FAU - Hornik, Christoph P
AU  - Hornik CP
CN  - Best Pharmaceuticals for Children Act-Pediatric Trials Network Administrative 
      Core Committee
LA  - eng
GR  - HHSN275201000001Z/HD/NICHD NIH HHS/United States
GR  - 1R25HD076475-01/HD/NICHD NIH HHS/United States
GR  - K24 HD058735/HD/NICHD NIH HHS/United States
GR  - R01 HD081044/HD/NICHD NIH HHS/United States
GR  - HHSN272201500001G/AI/NIAID NIH HHS/United States
GR  - HHSN272201500001C/AI/NIAID NIH HHS/United States
GR  - R25 HD076475/HD/NICHD NIH HHS/United States
GR  - HHSN275201000003I/HD/NICHD NIH HHS/United States
GR  - R18 FD005292/FD/FDA HHS/United States
GR  - UL1 TR001117/TR/NCATS NIH HHS/United States
GR  - HHSN272201500006C/AI/NIAID NIH HHS/United States
GR  - HHSN275201000001G/HD/NICHD NIH HHS/United States
GR  - T32 HD060558/HD/NICHD NIH HHS/United States
GR  - HHSN275201000003C/AA/NIAAA NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - J Pediatr Gastroenterol Nutr
JT  - Journal of pediatric gastroenterology and nutrition
JID - 8211545
RN  - 0 (Gastrointestinal Agents)
RN  - 63937KV33D (Erythromycin)
RN  - L4YEB44I46 (Metoclopramide)
SB  - IM
MH  - Enteral Nutrition/adverse effects
MH  - Erythromycin/*adverse effects/therapeutic use
MH  - Female
MH  - Gastroesophageal Reflux/drug therapy
MH  - Gastrointestinal Agents/*adverse effects/therapeutic use
MH  - Humans
MH  - Hyperkalemia/chemically induced/epidemiology
MH  - Incidence
MH  - Infant, Newborn
MH  - Infant, Premature
MH  - Infant, Premature, Diseases/*drug therapy
MH  - Intensive Care Units, Neonatal/*statistics & numerical data
MH  - Male
MH  - Metoclopramide/*adverse effects/therapeutic use
MH  - Pyloric Stenosis, Hypertrophic/chemically induced/epidemiology
MH  - Retrospective Studies
PMC - PMC4553109
MID - NIHMS673367
COIS- Conflicts of interest: The authors declare that they have no conflicts of 
      interest to disclose.
FIR - Berezny, Katherine Y
IR  - Berezny KY
FIR - Barrett, Jeffrey
IR  - Barrett J
FIR - Capparelli, Edmund
IR  - Capparelli E
FIR - Cohen-Wolkowiez, Michael
IR  - Cohen-Wolkowiez M
FIR - Kearns, Gregory L
IR  - Kearns GL
FIR - Laughon, Matthew
IR  - Laughon M
FIR - Muelenaer, Andre
IR  - Muelenaer A
FIR - O'Shea, T Michael
IR  - O'Shea TM
FIR - Paul, Ian M
IR  - Paul IM
FIR - van den Anker, John
IR  - van den Anker J
FIR - Wade, Kelly
IR  - Wade K
FIR - Walsh, Thomas J
IR  - Walsh TJ
FIR - Siegel, David
IR  - Siegel D
FIR - Taylor-Zapata, Perdita
IR  - Taylor-Zapata P
FIR - Zajicek, Anne
IR  - Zajicek A
FIR - Pagan, Alice
IR  - Pagan A
FIR - Anand, Ravinder
IR  - Anand R
FIR - Clemons, Traci
IR  - Clemons T
FIR - Simone, Gina
IR  - Simone G
EDAT- 2015/03/26 06:00
MHDA- 2016/05/27 06:00
PMCR- 2016/09/01
CRDT- 2015/03/26 06:00
PHST- 2015/03/26 06:00 [entrez]
PHST- 2015/03/26 06:00 [pubmed]
PHST- 2016/05/27 06:00 [medline]
PHST- 2016/09/01 00:00 [pmc-release]
AID - 10.1097/MPG.0000000000000792 [doi]
PST - ppublish
SO  - J Pediatr Gastroenterol Nutr. 2015 Sep;61(3):334-9. doi: 
      10.1097/MPG.0000000000000792.