TABLE 5.

Clinical studies of intravenous erythromycin for treatment of Ureaplasma respiratory tract infections in infants^a

Reference	Erythromycin dosage and routeb (mg/kg/day)	Duration of treatment (days)	No. and type of subjects	Outcomes and/or comments
Abele-Horn (3)	24-45, i.v.	9-14	5 infants <1,420 g birth weight	All 5 infants had BPD. Treatment resulted in an improved clinical course. No follow-up cultures were performed.
Baier (19)	40, i.v.	5 or 10	17 infants ≤1,160 g birth weight	This uncontrolled study was designed to assess eradication in tracheal secretions. Decision to treat was at the discretion of physician. 6/11 (55%) infants recultured after 15 days were positive. There was a trend towards an increased incidence of BPD in infants with persistence of Ureaplasma spp.
Bowman (34)	20, i.v.	7	19 infants <1,000 g birth weight	Among 19 culture-positive infants treated, 4 required a second course of treatment before tracheal cultures were negative. There was no difference in rate of BPD, duration of oxygen therapy, or time until discharge among treated infants who were culture positive in comparison to 102 culture-negative infants who were not treated.
Heggie (112)	20-50, i.v.	7-14	10 infants ≤1,000 g birth weight	Decision to treat was at the discretion of the physician. No significant differences were noted in development of BPD among infants who were culture positive in the trachea versus 20 infants who were culture negative. No follow-up cultures were performed.
Izraeli (128)	40, p.o.	10	3 infants ≤952 g birth weight	Ureaplasmas were not recovered during treatment but reappeared in tracheal secretions following cessation of therapy in two infants. One infant died from respiratory failure. No changes in clinical course were noted during treatment.
Jonsson (135)	40, p.o. or i.v.	10	14 infants ≤1,728 g birth weight	Infants culture-positive in trachea or nasopharynx were randomly treated. 12/14 had negative cultures posttreatment. One infant became negative after a second i.v. course of erythromycin. 8 infants who were not treated remained culture positive 2 weeks after initial culture. Treated infants did not differ from untreated infants with regard to duration of supplemental oxygen or development of BPD.
Lyon (183)	15, i.v.	7	34 infants ≤2,300 g birth weight	Infants were randomized to receive treatment before culture results were known. 9 were ureaplasma positive in trachea. Treatment did not affect cytokine levels or development or severity of BPD. No follow-up cultures were performed.
Mhanna (196)	Not stated	7-19	38 infants ≤975 g birth weight	This was a retrospective uncontrolled evaluation of infants with tracheal cultures positive for Ureaplasma spp. who were treated at the discretion of the physician. Treatment was not begun until an average of 2 weeks after birth. Treatment had no effect on BPD. No follow-up cultures were performed.
Pacifico (209)	Not stated	7-14	10 infants ≤1,500 g birth weight	Decision whether to treat was left to the physician. BPD occurred in 7/10 (70%) treated infants who were culture positive in the trachea versus 4/6 (66.7%) in untreated infants. Treated infants were of significantly lower gestational age, so the two groups were not truly comparable. No follow-up cultures were performed.
Waites (324)	25-40, i.v.	7-10	14 infants ≤1,500 g birth weight	This study was designed to assess eradication and relate serum drug levels to bacteriologic outcomes. 9/10 (90%) infants who received at least 7 days of treatment were culture negative in the trachea 3 to 4 days after the final dose.

^aThe studies listed are those published in journals indexed in the National Library of Medicine for which sufficient information was provided for meaningful evaluation and only one drug (erythromycin) possibly affecting ureaplasmas was administered. Individual case reports were not included.

^bi.v., intravenous; p.o., per os.