Effect of intravenous erythromycin on the colonic motility of children and young adults during colonic manometry.
OBJECTIVE
Erythromycin is successfully used as a gastroduodenal prokinetic agent. Given the limited available treatments for colonic dysmotility, further investigation into erythromycin's effect on colonic motility is warranted. We aimed to study the effect of erythromycin on colonic motility in pediatric patients with recalcitrant chronic constipation/encopresis and other suspected colonic motility disorders.


METHODS
Patients referred for colonic manometry were eligible for enrollment. Fasting motility was recorded for 1 to 2 hours, then erythromycin lactobionate (EL), 3 mg/kg, was administered intravenously, and colonic motility was monitored for 1 to 2 hours after erythromycin. Manometry was then continued per routine. The motility index (MI) of pressure tracings at each pressure transducer was calculated for each patient for a period of 15 and 60 minutes before and after EL infusion. Change in MI was compared by Wilcoxon signed rank test.


RESULTS
Twenty patients were enrolled. The most common indication was constipation with encopresis. Seventy percent of patients had normal colonic manometry, and 30% of patients demonstrated a neuropathy. Average MI for the 60-minute period before and after EL infusion were 254 +/- 74 mm Hg/h and 253 +/- 94 mm Hg/h, respectively (P = .55). Average MI for the 15-minute period before and after EL infusion were 64 +/- 23 mm Hg/15 min and 69 +/- 32 mm Hg/15 min, respectively (P = .45).


CONCLUSIONS
Administration of intravenous EL resulted in no changes in colonic MI in pediatric patients referred for colonic manometry. Further studies on potential colokinetic agents are warranted in this population of patients.
Dranove
Jason
J
Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN 46202, USA. jason.dranove@carolinashealthcare.org
Horn
Debra
D
Reddy
S Narasimha
SN
Croffie
Joseph
J
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003112:Colonic Pseudo-Obstruction / Q000188:drug therapy*; D003248:Constipation / Q000188:drug therapy*; D004688:Encopresis / Q000188:drug therapy*; D004917:Erythromycin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000494:pharmacology*; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008365:Manometry; D010865:Pilot Projects; D055815:Young Adult
D005765:Gastrointestinal Agents; C010948:erythromycin lactobionate; D004917:Erythromycin