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Gastrointestinal side effects after intravenous erythromycin lactobionate
British Journal of Clinical Pharmacology
|March 1, 1986
Summary
Intravenous erythromycin lactobionate infusion rates and plasma concentrations correlated with gastrointestinal symptoms like nausea and stomach discomfort. Erythromycin concentrations in gastric aspirates were pH-dependent, with some exceeding plasma levels.
Area of Science:
- Pharmacology
- Gastroenterology
- Clinical Medicine
Background:
- Erythromycin lactobionate is administered intravenously.
- Gastrointestinal and central nervous system (CNS) side effects are common with macrolide antibiotics.
Purpose of the Study:
- To investigate the relationship between intravenous erythromycin lactobionate infusion parameters and the incidence/severity of adverse effects.
- To explore erythromycin concentrations in gastric contents and their correlation with observed symptoms.
Main Methods:
- Ten healthy volunteers received intravenous erythromycin lactobionate infusions.
- Blood samples were collected serially, and gastric contents were aspirated.
- Adverse events (nausea, stomach discomfort, dizziness) were quantified using visual analogue scales.
Main Results:
- Infusion rate and plasma erythromycin concentrations significantly correlated with nausea and stomach discomfort (P < 0.001).
- Plasma erythromycin concentration also correlated with dizziness (P < 0.05).
- Gastric erythromycin concentrations were pH-dependent, with some samples showing concentrations 100-fold higher than plasma.
Conclusions:
- Intravenous erythromycin lactobionate administration is associated with dose- and concentration-dependent gastrointestinal and CNS symptoms.
- The presence of high erythromycin concentrations in gastric aspirates suggests local effects, but their origin remains uncertain due to potential bile contamination.