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Macrolides and gastrointestinal motility.

M A Pilot1, X Y Qin

  • 1Surgical Science Units, London Hospital Medical College, UK.

The Journal of Antimicrobial Chemotherapy
|July 1, 1988
PubMed
Summary
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Erythromycin, a common antibiotic, causes gastrointestinal side effects like nausea and vomiting due to increased upper gut activity. Newer macrolides, spiramycin and josamycin, do not appear to cause these adverse effects in dogs.

Area of Science:

  • Pharmacology
  • Gastroenterology
  • Drug Safety

Background:

  • Erythromycin is the first clinically used macrolide antibiotic.
  • It remains widely prescribed despite known gastrointestinal side effects.
  • The mechanism of these side effects requires further investigation.

Purpose of the Study:

  • To investigate the gastrointestinal effects of erythromycin in dogs.
  • To compare the effects of erythromycin with two other macrolides, spiramycin and josamycin.
  • To assess the impact of feeding status on erythromycin's gastrointestinal effects.

Main Methods:

  • Erythromycin, spiramycin, and josamycin were administered intravenously or orally to fasted and fed dogs.
  • Gastrointestinal motility was measured using implanted sensors.

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  • Observed clinical signs such as nausea and vomiting were recorded.

    • Main Results:

    • Erythromycin administration led to increased contractile activity in the stomach and upper small intestine.
    • Erythromycin caused nausea and vomiting in dogs, with inhibition of distal small bowel motility.
    • Spiramycin and josamycin did not produce similar gastrointestinal side effects in dogs under the same conditions.

    Conclusions:

    • Erythromycin's gastrointestinal side effects are linked to altered upper gastrointestinal motility.
    • The observed effects in dogs are comparable to those reported in humans.
    • 16-membered macrolides like spiramycin and josamycin may offer a safer alternative regarding gastrointestinal tolerability.