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Eur J Pediatr. 2019 Mar;178(3):301-314. doi: 10.1007/s00431-018-3287-7. Epub 2018 Nov 23.

Association between exposure to macrolides and the development of infantile hypertrophic pyloric stenosis: a systematic review and meta-analysis.

Author information

1
Neonatal Intensive Care Unit, Al-Adan hospital, Ministry of Health, Hadiya, Kuwait.
2
Online Research Club (http://www.onlineresearchclub.org/), Nagasaki, Japan.
3
Neurosurgery Department, El Sheikh Zayed Specialized Hospital, Giza, 41516, Egypt.
4
Faculty of Medicine, Minia University, Minia, 61519, Egypt.
5
Faculty of Medicine, Tanta University, Tanta, 31527, Egypt.
6
Faculty of Medicine, Alexandria University, Alexandria, 21111, Egypt.
7
Ain Shams University Hospital, Cairo, 11633, Egypt.
8
University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
9
Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Leading Graduate School Program, and Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
10
Evidence Based Medicine Research Group & Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam. nguyentienhuy@tdtu.edu.vn.
11
Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), Leading Graduate School Program, and Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan. nguyentienhuy@tdtu.edu.vn.

Abstract

Macrolides are bacteriostatic antibiotics with a broad spectrum of activity against Gram-positive bacteria. The aim of this study was to systematically review and meta-analyze the association between infantile hypertrophic pyloric stenosis (IHPS) and macrolides. Nine databases were searched systematically for studies with information on the association between macrolides and IHPS. We combined findings using random effects models. Our study revealed 18 articles investigating the association between macrolides and IHPS. There was a significant association between the development of IHPS and erythromycin (2.38, 1.06-5.39). The association was strong when erythromycin was used during the first 2 weeks of life (8.14, 4.29-15.45). During breastfeeding, use of macrolides showed no significant association with IHPS in infants (0.96, 0.61-1.53). IHPS was not associated with erythromycin (1.11, 0.9-1.36) or macrolides use during pregnancy (1.15, 0.98-1.36).Conclusions: There is an association between erythromycin use during infancy and developing IHPS in infants. However, no significant association was found between macrolides use during pregnancy or breastfeeding. Additional large studies are needed to further evaluate potential association with macrolide use. What is known? • Erythromycin intake in the first 2 weeks of life is associated with an increased risk of pyloric stenosis. What is New? • There is currently no evidence of significant association between macrolides use during pregnancy or breastfeeding and pyloric stenosis.

KEYWORDS:

Chemotherapy; Erythromycin; Hypertrophic pyloric stenosis; Infancy; Macrolides; Meta-analysis; Systematic review

PMID:
30470884
DOI:
10.1007/s00431-018-3287-7
[Indexed for MEDLINE]

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