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Murine Ileocolic Bowel Resection with Primary Anastomosis

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Erythromycin: prophylaxis against recurrent small bowel obstruction.

Emily Rea¹, Emma Husbands²

¹Palliative Medicine, St Anne's Hospice, Newport, UK.

BMJ Supportive & Palliative Care

|March 31, 2017

Summary

Erythromycin suspension effectively prevented recurrent small bowel obstruction in terminally ill patients, offering a longer-term benefit than standard prokinetics. This highlights erythromycin as a viable alternative for managing such symptoms.

Keywords:

Drug administration Supportive care

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Area of Science:

Gastroenterology
Palliative Care
Pharmacology

Background:

Small bowel obstruction (SBO) is a common complication in patients with terminal illness.
Standard prokinetic agents like metoclopramide and domperidone have potential long-term risks.
Effective management of SBO symptoms is crucial for patient comfort and quality of life.

Observation:

Three cases of terminally ill patients experiencing recurrent SBO were treated with erythromycin suspension.
Erythromycin demonstrated successful prevention of SBO recurrence in these patients.
Patients experienced sustained benefits from erythromycin over several months.

Findings:

Erythromycin suspension proved more effective than metoclopramide and domperidone in preventing SBO recurrence.
The prokinetic effect of erythromycin provided longer-term symptom management.
Erythromycin serves as a viable alternative or adjunct to standard prokinetics for SBO in palliative care.

Implications:

Erythromycin offers a potentially safer long-term prokinetic option for terminally ill patients at risk of SBO.
Further research is needed to define optimal timing and protocols for erythromycin use in SBO management.
Investigating alternative prokinetic agents to erythromycin is also warranted for comprehensive symptom control.