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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.
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.
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-Zithromax
and Biaxin 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. 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.
Journal of
Pediatrics September 2001;139:380-384
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