Effect of clarithromycin on esophageal motility

As clarithromycin (CLA), an antibiotic commonly used for Helicobacter pylor i eradication, stimulates gastroduodenal motility, we investigated whether it also stimulates esophageal motility, In 15 normal subjects, esophageal m otility was recorded using a low-compliance manometric system with two port s in the esophageal body, one port in the lower esophageal sphincter (LES), and five ports in the antroduodenal tract to monitor the occurrence of pha ses I-III of the migrating motor complex. Thirty minutes after the occurren ce of a duodenal phase III, we infused intravenously, randomly, and in a do uble-blind manner, CLA 100 mg in five subjects (group A), CLA 250 mg in fiv e subjects (group B), and normal saline in the remaining five subjects (gro up C), LES tone and post-deglutitive residual pressure, as well as the ampl itude and duration of the esophageal contractions, were measured each minut e and averaged over a post-infusion period of 30 min. Both group A and B sh owed a LES tone significantly higher than that of group C after CLA infusio n, whereas the post-deglutitive residual pressure was not significantly dif ferent from that of group C, The LES tone of group B was significantly high er than that of group A. Group B, but not group A, showed a wave amplitude and duration significantly higher than that of group C, In conclusion, CLA is able to stimulate LES tone and esophageal contractions with a dose-relat ed effect.