COULD ORAL ERYTHROMYCIN OPTIMIZE HIGH-ENERGY CONTINUOUS ENTERAL NUTRITION

Background: Intravenous erythromycin has previously been reported to s timulate gastric emptying, to inhibit gastric acid secretion and to st imulate pancreatic secretion during continuous gastric infusion of a l iquid diet in healthy volunteers. Aim: The aim of this study was to ev aluate the effects of oral erythromycin (160 mg/h) on gastrointestinal function under these conditions in seven healthy subjects. Method: Th is randomized double-blind cross-over study measured the gastric empty ing rate of nutrients, gastric acid secretion, gastric pH, jejunal flo w rate as well as biliopancreatic secretion and duodeno-caecal transit time during a 19.9 kJ/min continuous infusion of a nutrient solution (4.18 kJ/mL) in the antrum over a 6-h period by a perfusion method. Re sults: The nutrition was well tolerated except by one subject with pla cebo perfusion, During the 6-h period, total gastric volume and gastri c volume of nutrient decreased during erythromycin administration by 2 2 +/- 8 and 22 +/- 6%, respectively. Gastric acid secretion was not mo dified by erythromycin. Lipase and bile salt outputs were significantl y higher with erythromycin. The duodeno-caecal transit time was not st atistically different with drug and placebo (169 +/- 15 and 146 +/- 19 min, respectively). Conclusion: During continuous gastric infusion of a liquid diet, the effect of oral erythromycin on gastric emptying co uld be useful to optimize cyclic enteral nutrition or to enhance the t olerance of enteral nutrition.