title: Azithromycin in an older woman with diabetic gastroparesis.
abstract: Diabetic neuropathy is a common chronic complication of diabetes and cause of significant morbidity and mortality, because it may involve the autonomous and peripheral nervous systems. Autonomic diabetic neuropathy is a challenging chronic complication of long-standing diabetes manifested with hypotension, syncope, gastroparesis, diarrhea, constipation, bladder dysfunction, sexual dysfunction, cardiac arrest, and/or sudden death. We present a case of diabetic gastroparesis in an older woman. The patient was an 83-year-old woman with a 40-year history of type 2 diabetes who was admitted with hypoglycemia, malnutrition, persistent vomiting, and obstinate constipation. After several unsuccessful attempts with different therapies, we administered intravenous azithromycin (500 mg/day). After 3 days of treatment, vomiting was resolved and the patient evacuated normal feces, with notable improvement in the general conditions and metabolic control. Because diabetic gastroparesis frequently is difficult to manage clinically and there are few beneficial therapeutic choices available at present, the macrolide antibiotic azithromycin, which has strong prokinetic properties, may be a useful option in the treatment of this complex condition.
authors.affiliation: Geriatric Unit, Post-Graduate School of Geriatrics, University of Palermo, Italy.
authors.forename: Loredana
authors.initials: L
authors.lastname: Sutera
authors.forename: Ligia J
authors.initials: LJ
authors.lastname: Dominguez
authors.forename: Mario
authors.initials: M
authors.lastname: Belvedere
authors.forename: Ernesto
authors.initials: E
authors.lastname: Putignano
authors.forename: Laura
authors.initials: L
authors.lastname: Vernuccio
authors.forename: Anna
authors.initials: A
authors.lastname: Ferlisi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fazio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Costanza
authors.forename: Mario
authors.initials: M
authors.lastname: Barbagallo
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D018589:Gastroparesis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007262:Infusions, Intravenous
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin