Azithromycin in Early Infancy and Pyloric Stenosis
Azithromycin in Early Infancy and Pyloric Stenosis
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DOI：
10.1542/peds.2014-2026
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发表时间：
2015-03-01
期刊：
影响因子：
8
通讯作者：
Nylund, Cade M.
中科院分区：
文献类型：
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作者：
Eberly, Matthew D.;Eide, Matilda B.;Nylund, Cade M.
背景和目的：婴儿口服红霉素与婴儿肥厚性幽门狭窄（IHPS）有关。阿奇霉素的风险仍然未知。我们评估了暴露于口服阿奇霉素和红霉素和随后的发展IHPS.METHODS：2001年和2012年之间出生的儿童的回顾性队列研究之间的关联进行了利用军事卫生系统数据库。婴儿口服红霉素或阿奇霉素的门诊处方在生命的前90天内进行了评价IHPS的发展。具体的诊断和程序代码被用来识别IHPS的情况下。结果：在研究期间的1074236名儿童中，共有2466名发展IHPS。出生后14天内暴露于阿奇霉素可增加IHPS的风险（校正比值比[aOR]，8.26; 95%置信区间[CI]，2.62-26.0）; 15 - 42天暴露的aOR为2.98（95% CI，1.24-7.20）。红霉素和IHPS之间的关联也得到了证实。出生后前14天暴露于红霉素的aOR为13.3（95% CI，6.80-25.9），出生后15至42天暴露于红霉素的aOR为4.10（95% CI，1.69-9.91）。43和90天之间的生命没有关联与大环内酯类药物。结论：口服阿奇霉素和红霉素摄入的地方年轻的婴儿在发展IHPS的风险增加。如果接触发生在出生后的前2周，这种关联最强，但在2至6周的儿童中持续存在，尽管程度较低。
BACKGROUND AND OBJECTIVE: Use of oral erythromycin in infants is associated with infantile hypertrophic pyloric stenosis (IHPS). The risk with azithromycin remains unknown. We evaluated the association between exposure to oral azithromycin and erythromycin and subsequent development of IHPS.METHODS: A retrospective cohort study of children born between 2001 and 2012 was performed utilizing the military health system database. Infants prescribed either oral erythromycin or azithromycin as outpatients in the first 90 days of life were evaluated for development of IHPS. Specific diagnostic and procedural codes were used to identify cases of IHPS.RESULTS: A total of 2466 of 1 074 236 children in the study period developed IHPS. Azithromycin exposure in the first 14 days of life demonstrated an increased risk of IHPS (adjusted odds ratio [aOR], 8.26; 95% confidence interval [CI], 2.62-26.0); exposure between 15 and 42 days had an aOR of 2.98 (95% CI, 1.24-7.20). An association between erythromycin and IHPS was also confirmed. Exposure to erythromycin in the first 14 days of life had an aOR of 13.3 (95% CI, 6.80-25.9), and 15 to 42 days of life, aOR 4.10 (95% CI, 1.69-9.91). There was no association with either macrolide between 43 and 90 days of life.CONCLUSIONS: Ingestion of oral azithromycin and erythromycin places young infants at increased risk of developing IHPS. This association is strongest if the exposure occurred in the first 2 weeks of life, but persists although to a lesser degree in children between 2 and 6 weeks of age.