title: Erythromycin: prophylaxis against recurrent small bowel obstruction.
abstract: We describe three cases where erythromycin suspension has been used successfully in preventing recurrence of small bowel obstruction in patients with terminal illness and for whom it proved more effective than standard preparations such as metoclopramide and domperidone. These patients also experienced a longer term benefit over some months. With recent alerts over longer term use of metoclopramide and domperidone, we demonstrate that erythromycin is a viable alternative prokinetic in patients with terminal illness at risk of small bowel obstruction instead of or alongside metoclopramide and domperidone. More research is required to establish the point at which erythromycin should be considered in the management of symptoms. In addition, research into the possibility of a viable alternative to erythromycin is needed.
authors.affiliation: Palliative Medicine, St Anne's Hospice, Newport, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Rea
authors.affiliation: Department of Palliative Care, Gloucestershire Royal Hospital, Gloucester, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Husbands
mesh_terms: D000328:Adult; D004917:Erythromycin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007415:Intestinal Obstruction / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012008:Recurrence; D055502:Secondary Prevention; D013535:Suspensions; D019452:Terminally Ill
chemical_list: D005765:Gastrointestinal Agents; D013535:Suspensions; D004917:Erythromycin
keywords: Drug administration; Supportive care