Effect of intravenous clarithromycin on interdigestive gastroduodenal motility of patients with functional dyspepsia and Helicobacter pylori gastritis

Gastroduodenal motility of 16 patients complaining of functional dyspepsia and Helicobacter pylori gastritis was recorded by means of a low-compliance manometric system with four recording ports in the stomach and four in the duodenum. Clarithromycin (CLA) 250 mg (group A: 8 patients) or normal saline solution (group B: 8 patients) was infused intravenously randomly and in double-blind manner 30 min after the end of the first recorded activity front (AF) of the migrating motor complex or, in the absence of AFs, after 200 min of recording, continuing the recording until an AF was observed during the subsequent 200 min. CLA administration was followed by a typical gastroduodenal AF in a significantly higher number of patients than saline administration. In addition, the time-lag between the drug administration and the appearance of AFs was 22 min +/- 7.4 (mean +/- so), significantly shorter than after saline (109 +/- 56 min) and the CLA-related duodenal AFs showed a duration of 7.4 min +/- 1.6 in group A, significantly longer than that of the spontaneous AFs (3.5 min +/- 1), while in group B AF duration after saline was not significantly different from that of the spontaneous ones. In conclusion, clarithromycin is able to stimulate Cyclic interdigestive gastroduodenal motility. This prokinetic property of clarithromycin is not unexpected because it is a macrolide like erythromycin, the prokinetic activity of which is well known, and could be utilized for therapeutic uses.