Erythromycin gastrointestinal symptoms

Gastrointestinal symptoms were the most common adverse effects reported in a trial of azithromycin in disseminated Mycobacterium avium complex in 62 patients with AIDS (30). Erythromycin is a motilin receptor agonist (31-33). This mechanism may be at least partly responsible for the gastrointestinal adverse effects of macrolides. Azithromycin may act on gastrointestinal motility in a similar way to erythromycin, as it produces a significant increase in postprandial antral motility (34). 

Adverse reactions to clarithromycin are rare. The most common complaints relate to gastrointestinal symptoms, but these seldom require discontinuance of therapy. Clarithromycin, like erythromycin, inhibits cytochrome P-4S0 oxidases and, thus, can potentiate the actions of drugs metabolized by these enzymes. 

Gastrointestinal In 264 (28%) of 942 respondents who took oral erythromycin 1000 mg/ day for 10 days as prophylaxis for pertussis infection, there were some form adverse effects, of which the most common involved gastrointestinal symptoms, for example, diarrhea (16%), stomach ache (7.5%), nausea (3.6%), epigastric distress (2.1%), and abdominal distention (1.8%) [119 ]. 

Animals have been reported to develop similar symptoms to those seen in humans when larger doses are used. Horses are particularly sensitive to erythromycin induced gastrointestinal effects. At doses of >5mgkg day, dogs have been reported to develop ventricular arrhythmias. 

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