There is limited evidence reviewing the efficacy of oral erythromycin in people with gastroparesis. the occurrence of any grade 3 or 4 adverse event as defined by the National Institute of Allergy and Infectious Diseases (NIAID) program of the National Institute of Health (NIH), USA; NIAID 2003) of erythromycin (or other macrolide or its derivative) versus control (no treatment, placebo, prokinetic, antiemetic or low-dose tricyclic antidepressant) in adults with gastroparesis.To compare erythromycin (or other macrolide or its derivatives) versus control (no treatment, placebo, prokinetic, antiemetic or low-dose tricyclic antidepressant) for gastric emptying in adults with gastroparesis.To conduct a subgroup analysis within each comparison according to: It does not have UK marketing authorisation for treating gastroparesis and so this indication is an off-label use of erythromycin.

To compare erythromycin or other macrolides (e.g. erythromycin works for improving symptoms in people with gastroparesis.

The retrospective chart review (Dhir and Richter 2004) included a series of patients with dyspepsia and gastroparesis treated with a low-bulk diet and 50 to 100 mg oral erythromycin suspension 3 times a day and at bedtime. 2015;2015:970940. doi: 10.1155/2015/970940. At this time it should be reserved for the treatment of patients with diabetic gastroparesis who are resistant to or intolerant of other prokinetic agents. Erythromycin's effect on gastric emptying in patients with post-vagotomy-antrectomy gastroparesis is unknown.

Epub 2012 Aug 16.Curr Gastroenterol Rep. 2012 Aug;14(4):297-305. doi: 10.1007/s11894-012-0275-3.J Korean Surg Soc.

Re-searchers eventually determined that erythromycin stimulates motilin recep-tors in the GI tract. 2019 Nov;19(4):e291-e304. 12,14 of gastroparesis and other GI hypo-motility disorders. erythromycin elicited a premature phase 3 that started in the stomach. doi: 10.1111/j.1365-2982.2012.01991.x. For pregnant women who cannot tolerate these doses, 500 mg PO every 12 hours, 333 mg PO every 8 hours, or 250 mg PO 4 times daily for 14 days is recommended. 2015 May;35(5):299-305. doi: 10.1007/s40261-015-0281-y.Nat Rev Gastroenterol Hepatol.

One systematic review (Of the 5 studies in the systematic review, only 4 reported on change in symptom scores, and none assessed symptom improvement as the primary end point. 1996 Mar 29;121(13):402-5. doi: 10.1055/s-2007-1023931.Am J Gastroenterol. In the second and third studies, erythromycin stearate (base) 250 mg tablet or erythromycin ethylsuccinate 250 mg In healthy volunteers, an intravenous dose of 200 mg of erythromycin lactobionate induces strong gastric antral contractions and improves antroduodenal co‐ordination but does not result in a more distally propagated contraction in the fasted and fed states. doi: 10.1046/j.1365-2036.1997.148324000.x. The aim of this study was to determine if a single dose of intravenous erythromycin (1 mg/kg or 6 mg/kg) accelerates solid meal gastric emptying in patients with chronic symptomatic post-vagotomy-antrectomy gastroparesis. 2012 Dec;24(12):1111-e568. Erythromycin is a macrolide antibiotic that is licensed for treating and preventing infections. The macrolide antibiotic erythromycin has been known to be associated with increased gastrointestinal motility since its introduction more than 35 years ago. The pathophysiology, etiology, and diagnosis of gastroparesis and the management of malignancy-associated gastroparesis are discussed separately. If pharmacological treatment is required, metoclopramide, domperidone or erythromycin may be considered as motility agents. Human studies of both intravenous erythromycin and chronic oral erythromycin in patients with diabetic gastroparesis resistant to other prokinetic agents showed that gastric retention was indeed reduced and symptomatic improvement achieved.

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