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AAP Grand Rounds 3:25-26 (2000)
© 2000 American Academy of Pediatrics

GASTROENTEROLOGY AND NUTRITION

Pyloric Stenosis Associated With Erythromycin Administration to Neonates

Sources: (1) Patterson L, Peeden J, Sirlin S, et al. Hypertrophic pyloric stenosis in infants following pertussis prophylaxis with erythromycin—Knoxville, Tennessee, 1999. MMWR Morb Mortal Wkly Rep. 1999;48:1117–1120. (2) Honein MA, Paulozzi LJ, Himelright IM, et al. Infantile hypertrophic pyloric stenosis after pertussis prophylaxis with erythromycin: a case review and cohort study. Lancet. 1999;354: 2101–2105.

The first 20% of the full text of this article appears below.

Following 6 neonatal cases of pertussis in Knoxville, Tennessee, in February 1999 and recognition that a health care worker at the hospital where the babies were born was the most likely source of exposure, 200 exposed newborns were given erythromycin as post-exposure prophylaxis. The unexpected observation of 7 cases of infantile hypertrophic pyloric stenosis (IHPS) in 7 full-term infants (birth weights 3.1–4.4 kg) over a 2-week period in March, all of whom had received erythromycin prophylaxis, prompted an investigation by state and federal teams who reported their findings in the CDC’s MMWR. Honein et al, along with 3 of the original reporters, further described this occurrence in the Lancet. The 7 index patients included 6 males and 1 female, and ranged in age from 2–17 days (median 5 days) when erythromycin was begun. The duration of treatment was 10–18 days (median 14 days). Independent review of the 7 IHPS ultrasounds and 7 negative scans of . . . [Full Text of this Article]

Stanford T. Shulman, MD, FAAP1, Leslie L. Barton, MD, FAAP2 and Michael S. Hart, MD, FAAP3
1 Children’s Memorial Hospital, Chicago, IL
2 Pediatrics and Pediatric Infectious Diseases, University of Arizona, Tucson, AZ
3 Carilion Health Systems, Roanoke, VA