title: Effect of amoxicillin/clavulanate on gastrointestinal motility in children.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the effect of amoxicillin/clavulanate (A/C) on gastrointestinal motility.
  
  
  METHODS
  Twenty consecutive pediatric patients referred for antroduodenal manometry received 20 mg/kg of A/C into the small bowel lumen. In 10 patients (group A), A/C was given 1 hour after and in 10 (group B), 1 hour before ingestion of a meal. Characteristics of the migrating motor complex, including presence, frequency, amplitude, and propagation of duodenal phase III and phase I duration and phase II motility index (MI), were evaluated 30 minutes before and after A/C administration.
  
  
  RESULTS
  There were no statistically significant differences in age and sex between the 2 groups. Manometry studies were considered normal in 8 patients in each group. In group A, 2 patients developed duodenal phase III after receiving A/C, and no significant difference was found in the MI before and after the drug administration. In group B, 9 patients developed duodenal phase III (P <0.05 vs group A). All phase III occurred within a few minutes from the medication administration. Most duodenal phase III contractions were preceded by an antral component during fasting but never after the medication was administered in either of the 2 groups (P<0.001 vs fasting). In group B, the duration of duodenal phase I was shorter after drug administration (P<0.05). There was no significant difference in duodenal phase II MI before and after A/C administration for the 2 study groups.
  
  
  CONCLUSIONS
  In children, administration of A/C directly into the small bowel before a meal induces phase III-type contractions in the duodenum, with characteristics similar to those present in the fasting state. These data suggest the possible use of A/C as a prokinetic agent. Further studies are needed to clarify its specific mechanism of action and the group of patients most likely to benefit from its use.
authors.affiliation: Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA. rgomezsu@wfubmc.edu
authors.forename: Roberto
authors.initials: R
authors.lastname: Gomez
authors.forename: Sergio
authors.initials: S
authors.lastname: Fernandez
authors.forename: Ann
authors.initials: A
authors.lastname: Aspirot
authors.forename: Jaya
authors.initials: J
authors.lastname: Punati
authors.forename: Beth
authors.initials: B
authors.lastname: Skaggs
authors.forename: Hayat
authors.initials: H
authors.lastname: Mousa
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Lorenzo
mesh_terms: D000293:Adolescent; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D004386:Duodenum / Q000187:drug effects*; D005260:Female; D005765:Gastrointestinal Agents / Q000494:pharmacology*; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D007223:Infant; D008297:Male; D008365:Manometry; D009119:Muscle Contraction / Q000187:drug effects*; D009130:Muscle, Smooth / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents; D005765:Gastrointestinal Agents; D019980:Amoxicillin-Potassium Clavulanate Combination