Pyloric stenosis in the first weeks of life is a known adverse effect of the macro-lide antibiotic erythromycin, including following exposure via breast milk (1). Pyloric stenosis presents as non-bilious projectile vomiting with preserved appetite. It is treated surgically.In March 2015, a US team published a cohort study that included 2466 cases of pyloric stenosis in neonates or infants up to the age of 3 months among the 1 074 236 children identified in the US military health system database and born between 2001 and 2012 (2). It showed an increased risk of pyloric stenosis following exposure during the first 14 days of life to another macrolide, azithromycin, with an odds ratio (OR) of 8.3 (95% confidence interval % (95CI): 2.6 to 26.0), as well as following exposure to erythromycin, with an OR of 13.3 (95CI: 6.80 to 25.9). A statistically significant increase in the risk was also found in babies exposed between days 15 and 42 after birth, but not with later exposure.
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