Agonist effect of erythromycin and its analogues on motilin receptors. A new family of prokinetics? Clinical interest.

It has been known since long that erythromycin may cause unpleasant gastro-intestinal side-effects such as nausea and vomiting. Recent studies however show that at low doses erythromycin may have a beneficial effect. Erythromycin induces the migrating motor complex in the fasted state and after a meal it accelerates gastric emptying. Although largely preliminary, its effects on esophageal, small intestinal, colonic and biliary tract motility have now been studied in several pathological conditions. Erythromycin is certainly a powerful gastrokinetic. Its antibiotic properties are a disadvantage, but more powerful derivatives devoid of antibacterial properties may soon become available. They form a new family of prokinetics.