Erythromycin as a prokinetic agent: risk factors.

Erythromycin (ER) is an antibiotic with prokinetic activity. This property has led to its clinical use to improve gastric emptying in patients with gastroparesis. Several papers have reported the effectiveness of ER in such patients; however few of these studies have been well-conducted methodologically with evaluation of clinical endpoints and their results are often contradictory. A benefit/risk analysis prior to prescription of ER should take into account the numerous medication interactions of this drug as well as the prevention of cardiovascular complications, most notably torsade de pointes and cardiac arrest. The aim of this paper was to provide new insights into these adverse events and allow for better-informed prescription. Risk prevention requires prescription guidelines and effective communication among surgeons, anesthesiologists and pharmacists.