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. 1992 Mar;33(3):397–401. doi: 10.1136/gut.33.3.397

Erythromycin and the gut.

S M Catnach 1, P D Fairclough 1
PMCID: PMC1373836  PMID: 1568663

Abstract

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.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adachi H., Toda N., Hayashi S., Noguchi M., Suzuki T., Torizuka K., Yajima H., Koyama K. Mechanism of the excitatory action of motilin on isolated rabbit intestine. Gastroenterology. 1981 Apr;80(4):783–788. [PubMed] [Google Scholar]
  2. Armstrong D. N., Ballantyne G. H., Modlin I. M. Erythromycin for reflex ileus in Ogilvie's syndrome. Lancet. 1991 Feb 9;337(8737):378–378. doi: 10.1016/0140-6736(91)91026-q. [DOI] [PubMed] [Google Scholar]
  3. Depoortere I., Peeters T. L., Vantrappen G. Development of motilin receptors and of motilin- and erythromycin-induced contractility in rabbits. Gastroenterology. 1990 Sep;99(3):652–658. doi: 10.1016/0016-5085(90)90951-v. [DOI] [PubMed] [Google Scholar]
  4. Domschke W., Strunz U., Mitznegg P., Domschke S., Wünsch E., Demling L. Motilin and motilin analogues: mode of action. Scand J Gastroenterol Suppl. 1976;39:25–28. [PubMed] [Google Scholar]
  5. Downey K. M., Chaput de Saintonge D. M. Gastrointestinal side effects after intravenous erythromycin lactobionate. Br J Clin Pharmacol. 1986 Mar;21(3):295–299. doi: 10.1111/j.1365-2125.1986.tb05193.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Griffith R. S., Black H. R. Erythromycin. Med Clin North Am. 1970 Sep;54(5):1199–1215. [PubMed] [Google Scholar]
  7. Herishanu Y., Taustein I. The electromyographic changes by antibiotics. A preliminary study. Confin Neurol. 1971;33(1):41–45. [PubMed] [Google Scholar]
  8. Itoh Z., Nakaya M., Suzuki T., Arai H., Wakabayashi K. Erythromycin mimics exogenous motilin in gastrointestinal contractile activity in the dog. Am J Physiol. 1984 Dec;247(6 Pt 1):G688–G694. doi: 10.1152/ajpgi.1984.247.6.G688. [DOI] [PubMed] [Google Scholar]
  9. Itoh Z., Suzuki T., Nakaya M., Inoue M., Arai H., Wakabayashi K. Structure-activity relation among macrolide antibiotics in initiation of interdigestive migrating contractions in the canine gastrointestinal tract. Am J Physiol. 1985 Mar;248(3 Pt 1):G320–G325. doi: 10.1152/ajpgi.1985.248.3.G320. [DOI] [PubMed] [Google Scholar]
  10. Itoh Z., Suzuki T., Nakaya M., Inoue M., Mitsuhashi S. Gastrointestinal motor-stimulating activity of macrolide antibiotics and analysis of their side effects on the canine gut. Antimicrob Agents Chemother. 1984 Dec;26(6):863–869. doi: 10.1128/aac.26.6.863. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Janssens J., Peeters T. L., Vantrappen G., Tack J., Urbain J. L., De Roo M., Muls E., Bouillon R. Improvement of gastric emptying in diabetic gastroparesis by erythromycin. Preliminary studies. N Engl J Med. 1990 Apr 12;322(15):1028–1031. doi: 10.1056/NEJM199004123221502. [DOI] [PubMed] [Google Scholar]
  12. Klika L. J., Goodman J. M. Gastrointestinal tract symptoms from intravenously administered erythromycin. JAMA. 1982 Sep 17;248(11):1309–1309. doi: 10.1001/jama.1982.03330110017010. [DOI] [PubMed] [Google Scholar]
  13. Kondo Y., Torii K., Itoh Z., Omura S. Erythromycin and its derivatives with motilin-like biological activities inhibit the specific binding of 125I-motilin to duodenal muscle. Biochem Biophys Res Commun. 1988 Jan 29;150(2):877–882. doi: 10.1016/0006-291x(88)90474-3. [DOI] [PubMed] [Google Scholar]
  14. May E. F., Calvert P. C. Aggravation of myasthenia gravis by erythromycin. Ann Neurol. 1990 Oct;28(4):577–579. doi: 10.1002/ana.410280417. [DOI] [PubMed] [Google Scholar]
  15. Mozwecz H., Pavel D., Pitrak D., Orellana P., Schlesinger P. K., Layden T. J. Erythromycin stearate as prokinetic agent in postvagotomy gastroparesis. Dig Dis Sci. 1990 Jul;35(7):902–905. doi: 10.1007/BF01536806. [DOI] [PubMed] [Google Scholar]
  16. Nattel S., Ranger S., Talajic M., Lemery R., Roy D. Erythromycin-induced long QT syndrome: concordance with quinidine and underlying cellular electrophysiologic mechanism. Am J Med. 1990 Aug;89(2):235–238. doi: 10.1016/0002-9343(90)90305-w. [DOI] [PubMed] [Google Scholar]
  17. Omura S., Tsuzuki K., Sunazuka T., Marui S., Toyoda H., Inatomi N., Itoh Z. Macrolides with gastrointestinal motor stimulating activity. J Med Chem. 1987 Nov;30(11):1941–1943. doi: 10.1021/jm00394a001. [DOI] [PubMed] [Google Scholar]
  18. Otterson M. F., Sarna S. K. Gastrointestinal motor effects of erythromycin. Am J Physiol. 1990 Sep;259(3 Pt 1):G355–G363. doi: 10.1152/ajpgi.1990.259.3.G355. [DOI] [PubMed] [Google Scholar]
  19. Peeters T., Matthijs G., Depoortere I., Cachet T., Hoogmartens J., Vantrappen G. Erythromycin is a motilin receptor agonist. Am J Physiol. 1989 Sep;257(3 Pt 1):G470–G474. doi: 10.1152/ajpgi.1989.257.3.G470. [DOI] [PubMed] [Google Scholar]
  20. Putzi R., Blaser J., Lüthy R., Wehrli R., Siegenthaler W. Side-effects due to the intravenous infusion of erythromycin lactobionate. Infection. 1983 May-Jun;11(3):161–163. doi: 10.1007/BF01641296. [DOI] [PubMed] [Google Scholar]
  21. Qin X. Y., Pilot M. A., Thompson H. H., Maskell J. P. Comparison of the side effects and gastrointestinal motility observed after administration of erythromycin and josamycin to dogs. J Antimicrob Chemother. 1986 Dec;18(6):747–756. doi: 10.1093/jac/18.6.747. [DOI] [PubMed] [Google Scholar]
  22. Qin X., Pilot M., Thompson H., Maskell J. Effects of spiramycin on gastrointestinal motility. Chemioterapia. 1987 Jun;6(2 Suppl):319–320. [PubMed] [Google Scholar]
  23. Shanson D. C., Akash S., Harris M., Tadayon M. Erythromycin stearate, 1.5 g, for the oral prophylaxis of streptococcal bacteraemia in patients undergoing dental extraction: efficacy and tolerance. J Antimicrob Chemother. 1985 Jan;15(1):83–90. doi: 10.1093/jac/15.1.83. [DOI] [PubMed] [Google Scholar]
  24. Strunz U., Domschke W., Mitznegg P., Domschke S., Schubert E., Wünsch E., Jaeger E., Demling L. Analysis of the motor effects of 13-norleucine motilin on the rabbit, guinea pig, rat, and human alimentary tract in vitro. Gastroenterology. 1975 Jun;68(6):1485–1491. [PubMed] [Google Scholar]
  25. Tomomasa T., Kuroume T., Arai H., Wakabayashi K., Itoh Z. Erythromycin induces migrating motor complex in human gastrointestinal tract. Dig Dis Sci. 1986 Feb;31(2):157–161. doi: 10.1007/BF01300701. [DOI] [PubMed] [Google Scholar]
  26. Yajima H., Kai Y., Ogawa H., Kubota M., Mori Y. Structure-activity relationships of gastrointestinal hormones: motilin, GIP, and [27-TYR]CCK-PZ. Gastroenterology. 1977 Apr;72(4 PT2):793–796. [PubMed] [Google Scholar]
  27. Zara G. P., Thompson H. H., Pilot M. A., Ritchie H. D. Effects of erythromycin on gastrointestinal tract motility. J Antimicrob Chemother. 1985 Jul;16 (Suppl A):175–179. doi: 10.1093/jac/16.suppl_a.175. [DOI] [PubMed] [Google Scholar]

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