Erythromycin and the gut

• Published in: Gut Vol. 33; no. 3; pp. 397 - 401
• Main Authors: Catnach, S M, Fairclough, P D
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Society of Gastroenterology 01.03.1992; BMJ; BMJ Publishing Group LTD
• Subjects: Animals; Biological and medical sciences; Digestive System - drug effects; Dogs; Drug toxicity and drugs side effects treatment; Erythromycin - pharmacology; Erythromycin - therapeutic use; Gastrointestinal Motility - drug effects; Guinea Pigs; Humans; Medical sciences; Motilin - physiology; Pharmacology. Drug treatments; Rabbits; Rats; Receptors, Gastrointestinal Hormone - drug effects; Receptors, Neuropeptide; Toxicity: digestive system; Human; Motility; Toxicity; Digestive diseases; Intestinal disease; Erythromycin; Gastrointestinal
• ISSN: 0017-5749; 1468-3288; 1458-3288
• DOI: 10.1136/gut.33.3.397

The commonly reported gastrointestinal side effects that occur with erythromycin are related to its prokinetic action on the gut, mediated, at least in part, by its motilin receptor stimulating activity. This action may be of clinical use in conditions associated with gastrointestinal hypomotility such as diabetic gastroparesis and intestinal pseudo-obstruction, although further work needs to be done to establish the long term therapeutic uses of erythromycin in these disorders. Macrolide compounds with no antibacterial properties but which have a pronounced prokinetic action on the gut have already been synthesised and are currently being developed for future use in man. These 'motilides' should provide a useful addition to our rather limited armamentarium of effective gastrointestinal prokinetic agents.