Role of erythromycin for treatment of incipient chronic lung disease in preterm infants colonised with Ureaplasma urealyticum

Ureaplasma urealyticum is frequently isolated from tracheal aspirates of ve ry low birthweight infants who go on to develop chronic lung disease. The u se of erythromycin has been advocated in ventilated very low birthweight in fants who are colonised with U. urealyticum, although the association betwe en U. urealyticum and chronic lung disease remains controversial. There are only two randomised, controlled trials involving a total of 37 U. urealyti cum-positive very low birthweight infants. Both trials failed to demonstrat e a reduction in the incidence of chronic lung disease after 7 or 10 days o f erythromycin. On the other hand, there are reports of rare but serious ad verse effects of erythromycin in newborn infants including sudden cardiovas cular compromise and hypertrophic pyloric stenosis. We conclude that, at pr esent, there is insufficient evidence to support the use of erythromycin fo r the treatment of incipient chronic lung disease in very low birthweight i nfants colonised with U. urealyticum.