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Failure of erythromycin to eliminate airway colonization with ureaplasma urealyticum in very low birth weight infants.doc

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Failure of erythromycin to eliminate airway colonization with ureaplasma urealyticum in very low birth weight infants

BMC Pediatrics BioMedCentral Research article Open Access Failure of erythromycin to eliminate airway colonization with ureaplasma urealyticum in very low birth weight infants R John Baier*1, John Loggins2 and Thomas E Kruger1 Address: 1Department of Pediatrics, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, Louisiana 71130-3932, USA and 2Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, Louisiana 71130-3932, USA Email: R John Baier* - jbaier@; John Loggins - jloggi@; Thomas E Kruger - dkruger1@ * Corresponding author Published: 04 September 2003 Received: 16 April 2003 Accepted: 04 September 2003 BMC Pediatrics 2003, 3:10 This article is available from: /1471-2431/3/10 ? 2003 Baier et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the articles original URL. Abstract Background: Airway colonization of mechanically ventilated very low birth weight infants (birth weight 1500 grams) by Ureaplasma urealyticum (Uu) is associated with an increased risk of bronchopulmonary dysplasia (BPD). While Uu is sensitive to erythromycin in vitro, the efficacy of intravenous (IV) erythromycin to eliminate Uu from the airways has not been studied. Methods: 17 very low birth weight infants with Uu positive tracheal aspirate (TA) cultures were randomized to either 5 (8 infants) or 10 days (9 infants) of IV erythromycin lactobionate (40 mg/ kg/day in 3 divided doses). Tracheal aspirate cultures for Uu were performed on days 0, 5, 10 and 15. Results: Intravenous erythromycin failed to eliminate airway colonization in a large proportion of infants regardless of whether they received 5 or 10 days of treatment. Ureaplasma urealyticum was isolated from 4/15 (27%) of TAs obtained at 5 days, 5/12 TAs (42%) obtained