Weight gain and theophylline

There was a time when a cynic on a neonatal ward round in the UK might have thought prescribing for preterm infants could be made simpler and less tedious if a drug company produced a syrup containing theophylline, vitamins and a modest amount of sodium. As time passed it might have been commercially viable to have added some phosphate, or even provided some equivalent to the sophisticated triphasic contraceptive blister packs, containing a graded dexamethasone course with or without pulsed antibiotics. A few years ago the preterm neonatal elixir would certainly have contained cisapride. We are now at a stage when prokinetic free and steroid unenhanced products would be enjoying a market advantage, but methylxanthines have to a large extent preserved a squeaky clean image.

Carnielli and colleagues (page F39) show increased carbohydrate utilisation in neonates prescribed intravenous aminophylline, and suggest a possible adverse effect on growth. In their review, Sinha and Donn (page …