Monday October 8, 2001

Antibiotic Linked to Intestinal Problem in Infants

NEW YORK (Reuters Health) - Giving young infants the antibiotic 
erythromycin--particularly in the first 2 weeks of life--raises 
their 
risk of a gastrointestinal complication that may require surgery, 
researchers report.

Investigators also found a possible association between a 
complication 
called infantile hypertrophic pyloric stenosis (IHPS) and a mother's 
use 
of certain antibiotics in the last 10 weeks of pregnancy.

IHPS occurs when the pylorus, a tube leading from the stomach to 
the 
small intestine, becomes enlarged. This blocks the stomach's outlet 
and 
causes projectile vomiting and subsequent weight loss and 
dehydration in 
infants.

IHPS normally arises when babies are about one month old and it is 
the 
most common cause of abdominal surgery in infancy, researchers 
note in 
the September issue of the Journal of Pediatrics.

A connection between erythromycin and IHPS has been suspected, 
and the 
new findings confirm the link, according to Dr. Barbara E. Mahon and 
colleagues at Indiana University School of Medicine in Indianapolis.

However, the researchers also stress the importance of keeping the 
risk 
in context, since the chances of any infant suffering the 
complication 
are low. In their study of nearly 15,000 infants, 0.3% developed 
IHPS. 
Among the 226 infants given erythromycin in their first 2 weeks, 
2.65% 
developed IHPS.

In most cases, the newborns were given the antibiotic because their 
mothers had chlamydia infections.

Mahon's team also saw some evidence that a mother's use of 
erythromycin 
or one of two related antibiotics--azithromycin and clarithromycin-
-might 
be linked to IHPS, but the finding was not statistically significant.

There was no risk associated with topical erythromycin ointments 
given to 
infants for pink eye, the report indicates.

``This study confirms an association between systemic erythromycin 
in 
infants and subsequent IHPS, with the highest risk in the first 2 
weeks 
of age,'' Mahon's team writes. The authors add that maternal 
antibiotic 
use and IHPS should be studied further.

Doctors should use caution in prescribing the antibiotic in early 
infancy, the researchers urge. And when it is prescribed, ''prudence 
dictates that parents should be informed of the risk and symptoms 
of 
IHPS,'' they add.

SOURCE: Journal of Pediatrics 2001;139:380-384.