Hypertrophic Pyloric Stenosis in Infants Following Pertussis Prophylaxis With erythromycin--Knoxville, Tennessee, 1999

MMWR Morb Mortal Wkly Rep. 1999 Dec 17;48(49):1117-20.

Abstract

In February 1999, pertussis was diagnosed in six neonates born at hospital A in Knoxville, Tennessee. Because a health-care worker at hospital A was most likely the source of exposure, the local health department recommended on February 25, 1999, that erythromycin be prescribed as postexposure prophylaxis for the approximately 200 infants born at hospital A during February 1-24, 1999. In March 1999, local pediatric surgeons noticed an increased number of cases of infantile hypertrophic pyloric stenosis (IHPS) in the area, with seven cases occurring during a 2-week period. All seven IHPS cases were in infants born in hospital A during February who were given erythromycin orally for prophylaxis following possible exposure to pertussis, although none had pertussis diagnosed. The Tennessee Department of Health and CDC investigated the cluster of IHPS cases and its possible association with use of erythromycin. This report summarizes the results of the investigation, which suggest a causal role of erythromycin in this cluster of IHPS cases.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / therapeutic use
  • Antibiotic Prophylaxis / adverse effects*
  • Cluster Analysis
  • Cohort Studies
  • Erythromycin / adverse effects*
  • Erythromycin / therapeutic use
  • Humans
  • Hypertrophy
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Professional-to-Patient
  • Pyloric Stenosis / chemically induced*
  • Pyloric Stenosis / epidemiology*
  • Tennessee / epidemiology
  • Whooping Cough / prevention & control*
  • Whooping Cough / transmission

Substances

  • Anti-Bacterial Agents
  • Erythromycin