About 200 babies at a Knoxville, Tenn. hospital were given oral erythromycin because of a whooping cough outbreak earlier this year, and seven later developed pyloric stenosis, the Centers for Disease Control and Prevention (CDC) said.
     Normally, just one baby in 200 would develop the disorder, in which a stomach muscle enlarges and prevents food from passing into the small intestine, researchers said.
     “The result is forceful or projectile vomiting,” said Margaret Honein of the CDC’s National Center for Environmental Health.
     Investigators concluded there was “an association between taking the antibiotic erythromycin and being at an increased risk of pyloric stenosis,” said Honein.
     The seven infants, all less than three weeks of age, underwent surgery and have recovered.

Successful Sugeries
“The surgery for pyloric stenosis is considered very safe and effective and all of the seven infants in this investigation recovered completely and are doing well,” Honein said.
     Because whooping cough can be fatal in very young infants, the CDC urged doctors to carefully evaluate the risks and benefits of erythromycin in babies who are less than a month old.
     “We suggest that physicians talk to parents about the possible risk of pyloric stenosis that could occur and advise the parents to watch for signs that the infant may be developing pyloric stenosis,” Honein said.
     Erythromycin is the recommended treatment for newborns with whooping cough and is also used to prevent the disease when infants may have been exposed to someone who has symptoms of the highly contagious illness.

CDC Backs Recommendation
“CDC does still recommend that erythromycin be used following exposure to a known case of pertussis,” Honein said.
     “In newborns, pertussis, or whooping cough, is a very serious disease and can cause severe complications. About 72 percent of kids less than six months old who get whooping cough are hospitalized for it,” she said.

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