title: Combination of erythromycin and propranolol for treatment of childhood cyclic vomiting syndrome: a novel regimen.
abstract: OBJECTIVE
  This study aimed to evaluate the erythromycin efficacy in childhood cyclic vomiting syndrome.
  
  
  BACKGROUND
  Cyclic vomiting syndrome (CVS) is an unusual cause of episodic emesis in children and erythromycin is an effective treatment.
  
  
  METHODS
  In this prospective study, 301 patients with a final diagnosis of CVS enrolled in two separated groups. The first group received erythromycin for 7 days and propranolol for at least 9 months (n=155). The second group was treated with propranolol alone for at least 9 months (n=146). These two groups were compared for response to the treatment and the recurrence of symptoms after treatment completion. Relationship of response, recurrence, and characteristics of the disease was assessed.
  
  
  RESULTS
  Both groups showed a significant difference in terms of response to treatment (P=0.002), however the recurrence after treatment completion had no considerable difference (P=0.563). There was no relationship between CVS characteristics and these two items (response and recurrence).
  
  
  CONCLUSIONS
  In our point of view, the addition of erythromycin to standard propranolol treatment can improve the response to treatment, although it has no significant effect on recurrence of CVS symptoms. We suggest the use of erythromycin for 7 days in addition to CVS standard therapy.
authors.affiliation: Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Haghighat
authors.affiliation: Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Seyed Mohsen
authors.initials: SM
authors.lastname: Dehghani
authors.affiliation: Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Iraj
authors.initials: I
authors.lastname: Shahramian
authors.affiliation: Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mohammad Hadi
authors.initials: MH
authors.lastname: Imanieh
authors.affiliation: Children and Adolescents Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Teimouri
authors.affiliation: Children and Adolescents Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Noor Mohammad
authors.initials: NM
authors.lastname: Noori
keywords: Cyclic Vomiting Syndrome; Erythromycin; Propranolol; Therapy