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Erythromycin Dose of 70 mg Accelerates Gastric Emptying as Effectively as 200 mg in the Critically Ill
Author(s) -
Kolnik Lyle,
Ferrone Marcus
Publication year - 2006
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0115426506021005534
Subject(s) - gastric emptying , medicine , erythromycin , placebo , gastroenterology , saline , critically ill , anesthesia , stomach , antibiotics , alternative medicine , pathology , microbiology and biotechnology , biology
Objective: To compare the effectiveness of 70‐mg and 200‐mg doses of IV erythromycin in improving gastric emptying in critically ill patients. Design: Gastric emptying was measured on consecutive days; day 1 (pretreatment), day 2 (posttreatment) after an IV infusion of either 70 or 200 mg erythromycin or saline placebo (0.9%), in a randomized double‐blind fashion. Setting: Mixed medical/surgical intensive care unit, tertiary referral. Patients and Participants: Thirty‐five randomly selected, mechanically ventilated, enterally fed critically ill patients (median APACHE II score 19 on admission). Interventions: On day 2, either 70 or 200 mg erythromycin or saline was administered IV over 20 min. Measurements and Results: Gastric emptying was measured using the [ 13 C]octanoic acid breath test. The gastric emptying coefficient (GEC) and half‐emptying time (t ½ ) were calculated from the area under the 13 CO 2 ‐recovery curve. Pretreatment gastric emptying measurements were similar in all 3 patient groups. Treatment with both doses of erythromycin significantly reduced the gastric t ½ : 70 mg, 98 min (IQR 88–112); 200 mg, 86 min (75–104); vs placebo, 122 min (102–190) ( p < .05). The GEC was higher with both doses of erythromycin: 70 mg, 3.8 (3.3–4.0); 200 mg, 4.0 (3.6–4.2); vs placebo, 2.9 (2.5–3.7) ( p < .05). There was no difference in gastric emptying posttreatment between the 2 doses of erythromycin. The effect of erythromycin was greatest in patients with delayed gastric emptying. Conclusions: Treatment with 70 and 200 mg IV erythromycin is equally effective in accelerating gastric emptying in the critically ill.