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The risks and benefits of cisapride
  1. PAMELA CAIRNS, Consultant Neonatologist
  1. Directorate of Children’s Services
  2. Neonatal Medicine
  3. St Michael’s Hospital
  4. Bristol BS2 8EG, UK

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    Editor,—I read with interest the annotation by Lander and Desai discussing cisapride.1 They conclude that the case against cisapride as a safe and useful agent in premature neonates has not been proved.

    As the three main indications for cisapride in the newborn (gastro-oesophageal reflux, postoperative ileus, and intestinal dysmotility of prematurity) are self resolving with time, the only useful study design is a randomised controlled trial (RCT).

    There are two small published RCTs on the use of cisapride in the newborn. Enriquez et al randomised infants at the initiation of feeds and reported no difference between cisapride and placebo in the time taken to full feeds.2 Landeret al randomised neonates > 32 weeks’ gestation with postoperative ileus to cisapride or placebo …

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