Gastrointestinal motor effects of erythromycin

M. F. Otterson, S. K. Sarna

Research output: Contribution to journalArticlepeer-review

135 Scopus citations


We studied the small intestinal motor effects of oral and intravenous (IV) erythromycin in 10 conscious dogs. After control recordings with placebo, oral or iv erythromycin was given at 40% of the migrating motor complex (MMC) cycle. Recordings were made after administration until normal contractile activity had returned or 12 h postdrug administration. Low doses initiated a premature MMC. High doses, however, prolonged the MMC cycle length. Erythromycin reduced the MMC propagation velocity at all doses. Both oral and iv erythromycin induced amyogenesia. During this pattern, electrical control activity was obliterated in the proximal and destabilized in the distal small intestine. Erythromycin also increased the incidence of retrograde giant contractions (RGCs) and vomiting. These effects occurred within the first 2 h after oral and within the first 30 min after iv administration. The incidence of giant migrating contractions (GMCs) increased significantly from 5 to 12 h but not from 0 to 5 h after administration. The distance of origination of GMCs from the ileocolonic junction was significantly increased from 5 to 12 h. The amplitude ratio, duration, and velocity of migration of GMCs induced after erythromycin were similar to control values. Clusters of coordinated antral and duodenal contractions also occurred early after administration. Our findings suggest that erythromycin has multiple motor effects on the stomach and small intestine. Diarrhea, abdominal cramping, and vomiting associated with erythromycin may be related to increased incidence of GMCs and RGCs. Erythromycin has a biphasic effect on MMC cycle length, initiating premature MMCs at low doses and prolonging their cycle length at higher doses. The stimulation of coordinated gastroduodenal clustered contractions may aid in gastric emptying.

Original languageEnglish (US)
Pages (from-to)G355-G363
JournalAmerican Journal of Physiology - Gastrointestinal and Liver Physiology
Issue number3 22-3
StatePublished - 1990
Externally publishedYes


  • Abdominal cramps
  • Amyogenesia
  • Antibiotics
  • Clustered contractions
  • Diarrhea
  • Electrical control activity
  • Giant migrating contractions
  • Migrating motor complex
  • Motility
  • Nausea
  • Opioids
  • Peristalsis
  • Retrograde giant contractions
  • Slow wave
  • Vomiting

ASJC Scopus subject areas

  • Physiology
  • Hepatology
  • Gastroenterology
  • Physiology (medical)


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