Infantile hypertrophic pyloric stenosis after pertussis prophylaxis with erythromycin: a case review and cohort study

@article{Honein1999InfantileHP,
  title={Infantile hypertrophic pyloric stenosis after pertussis prophylaxis with erythromycin: a case review and cohort study},
  author={Margaret A. Honein and L Paulozzi and I Himelright and B. Lee and JD Cragan and L Patterson and A. Correa and Sarah Hall and J. David Erickson},
  journal={The Lancet},
  year={1999},
  volume={354},
  pages={2101-2105}
}

Tables from this paper

Hypertrophic pyloric stenosis in infants following pertussis prophylaxis with erythromycin--Knoxville, Tennessee, 1999.
TLDR
The Tennessee Department of Health and CDC investigated a cluster of cases of infantile hypertrophic pyloric stenosis (IHPS) in the area and suggested a causal role of erythromycin in this cluster of IHPS cases.
Maternal and infant use of erythromycin and other macrolide antibiotics as risk factors for infantile hypertrophic pyloric stenosis.
TLDR
This study confirms an association between systemic erythromycin in infants and subsequent IHPS, with the highest risk in the first 2 weeks of age, and a possible association with maternal macrolide therapy in late pregnancy requires further study.
Azithromycin in Early Infancy and Pyloric Stenosis
TLDR
Ingestion of oral azithromycin and erythromycin places young infants at increased risk of developing infantile hypertrophic pyloric stenosis, and 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.
Erythromycin use during pregnancy in relation to pyloric stenosis.
TLDR
No evidence of an increased risk of pyloric stenosis among infants born to mothers exposed to erythromycin during pregnancy is found.
Very early exposure to erythromycin and infantile hypertrophic pyloric stenosis.
TLDR
The significant increase in pyloric stenosis in children with very early exposure to erythromycin is consistent with reports of other investigators and should be weighed carefully prior to initiating such therapy in young infants.
Risk of Infantile Hypertrophic Pyloric Stenosis after Maternal Postnatal Use of Macrolides
TLDR
The use of macrolides during breast-feeding increases the risk of infantile hypertrophic pyloric stenosis, and after stratification for gender they were 10.3 [95% confidence interval 1.2–92.3] for girls and 2.0 (95% CI 0.5–8.4) for boys.
Prenatal Prescription of Macrolide Antibiotics and Infantile Hypertrophic Pyloric Stenosis
The Association of Erythromycin and Infantile Hypertrophic Pyloric Stenosis
TLDR
Evidence suggests an association between early postnatal erythromycin exposure and infantile hypertrophic pyloric stenosis (IHPS), and the implications of the reported findings with erystromycin on the benefit-risk profiles of newer macrolides and azalides must be considered.
Use of macrolides in mother and child and risk of infantile hypertrophic pyloric stenosis: nationwide cohort study
TLDR
Treatment of young infants with macrolide antibiotics was strongly associated with infantile hypertrophic pyloric stenosis (IHPS) and should therefore only be administered if potential treatment benefits outweigh the risk.
Congenital Anomalies and Surgical Disorders of the Stomach
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References

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Infants with infantile hypertrophic pyloric stenosis (IHPS) born from 1983 to 1988 and recorded in the California Birth Defects Monitoring Program (CBDMP) database were compared with their birth
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In an analysis of clinical and demographic variables, the development of IHPS was found to be associated with low parity status (regardless of maternal age), and the preterm cases had a longer interval from birth to onset of symptoms, compared with those born at term.
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An apparent decline in the rate of infantile hypertrophic pyloric stenosis (IHPS) is investigated and the characteristics of children with IHPS and any associated malformations are examined to examine.
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Ultrasound imaging should be reserved for those cases where clinical examination is negative and should be carried out by sonographers who see enough cases to maintain their expertise, says this prospective study of patients referred to the surgical team with a possible diagnosis of pyloric stenosis.
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Infantile hypertrophic pyloric stenosis is a relatively common condition and there is some recent evidence that the incidence is increasing in this country, but meticulous assessment and correction of fluid and electrolyte imbalance is essential preoperatively.
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TLDR
An algorithm for management of patients with suspected IHPS is proposed and Prompt examination by an experienced examiner is key to the evaluation of such patients.
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The morphometric parameters are highly accurate in differentiating IHPS from a normal pylorus, muscle thickness being the most discriminating parameter.
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