Y Bai1, J-F Guo, Z-S Li. 1. Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Abstract
BACKGROUND: Studies evaluating the effect of erythromycin on patients with acute upper gastrointestinal bleeding (UGIB) had been reported, but the results were inconclusive. AIMS: To compare erythromycin with control in patients with acute UGIB by performing a meta-analysis. METHODS: Electronic databases including PubMed, EMBASE and the Cochrane Library, Science Citation Index, were searched to find relevant randomised controlled trials (RCTs). Two reviewers independently identified relevant trials evaluating the effect of erythromycin on patients with acute UGIB. Outcome measures were the incidence of empty stomach, need for second endoscopy, blood transfusion, length of hospital stay, endoscopic procedure time and mortality. RESULTS: Four RCTs including 335 patients were identified. Meta-analysis demonstrated the incidence of empty stomach was significantly increased in patients receiving erythromycin (active group 69%, control group 37%, P<0.00001). The need for second endoscopy, amount of blood transfusion and the length of hospital stay were also significantly reduced (all P<0.05). A trend for shorter endoscopic procedure time and decreased mortality rate was observed. CONCLUSIONS: Prophylactic erythromycin is useful for patients with upper gastrointestinal bleeding to decrease the amount of blood in the stomach and reduce the need for second endoscopy, amount of blood transfusion. It may shorten the length of hospital stay, but its effects on mortality need further larger trials to be confirmed.
BACKGROUND: Studies evaluating the effect of erythromycin on patients with acute upper gastrointestinal bleeding (UGIB) had been reported, but the results were inconclusive. AIMS: To compare erythromycin with control in patients with acute UGIB by performing a meta-analysis. METHODS: Electronic databases including PubMed, EMBASE and the Cochrane Library, Science Citation Index, were searched to find relevant randomised controlled trials (RCTs). Two reviewers independently identified relevant trials evaluating the effect of erythromycin on patients with acute UGIB. Outcome measures were the incidence of empty stomach, need for second endoscopy, blood transfusion, length of hospital stay, endoscopic procedure time and mortality. RESULTS: Four RCTs including 335 patients were identified. Meta-analysis demonstrated the incidence of empty stomach was significantly increased in patients receiving erythromycin (active group 69%, control group 37%, P<0.00001). The need for second endoscopy, amount of blood transfusion and the length of hospital stay were also significantly reduced (all P<0.05). A trend for shorter endoscopic procedure time and decreased mortality rate was observed. CONCLUSIONS: Prophylactic erythromycin is useful for patients with upper gastrointestinal bleeding to decrease the amount of blood in the stomach and reduce the need for second endoscopy, amount of blood transfusion. It may shorten the length of hospital stay, but its effects on mortality need further larger trials to be confirmed.
Authors: Bong Sik Matthew Kim; Bob T Li; Alexander Engel; Jaswinder S Samra; Stephen Clarke; Ian D Norton; Angela E Li Journal: World J Gastrointest Pathophysiol Date: 2014-11-15
Authors: Jun Uk Lim; Jae Jun Park; Young Hoon Youn; Sunyong Kim; Jung Won Jeon; Sung Won Jung; Hyun Phil Shin; Jae Myung Cha; Kwang Ro Joo; Joung Il Lee Journal: Dig Dis Sci Date: 2014-10-18 Impact factor: 3.199
Authors: Mandip Rai; Mary Cooper; Scott Shulman; Dan Kottachchi; Sandra Nelles; Mark Macmillan; Steven Heitman; Alan Barkun; Frances Tse; Lawrence Hookey Journal: J Can Assoc Gastroenterol Date: 2019-11-21
Authors: Shoba Theivanayagam; Roxanne G Lim; William J Cobell; Jayashree T Gowda; Michelle L Matteson; Abhishek Choudhary; Matthew L Bechtold Journal: Saudi J Gastroenterol Date: 2013 Sep-Oct Impact factor: 2.485
Authors: Rubayat Rahman; Douglas L Nguyen; Umair Sohail; Ashraf A Almashhrawi; Imran Ashraf; Srinivas R Puli; Matthew L Bechtold Journal: Ann Gastroenterol Date: 2016-05-20