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Randomized Controlled Trial
. 2017 Nov;32(6):1002-1009.
doi: 10.3904/kjim.2016.117. Epub 2017 Mar 28.

Erythromycin infusion prior to endoscopy for acute nonvariceal upper gastrointestinal bleeding: a pilot randomized controlled trial

Hee Kyong Na  1 , Hwoon-Yong Jung  1 , Dong Woo Seo  2 , Hyun Lim  1 , Ji Yong Ahn  1 , Jeong Hoon Lee  1 , Do Hoon Kim  1 , Kee Don Choi  1 , Ho June Song  1 , Gin Hyug Lee  1 , Jin-Ho Kim  1
Affiliations
Randomized Controlled Trial

Erythromycin infusion prior to endoscopy for acute nonvariceal upper gastrointestinal bleeding: a pilot randomized controlled trial

Hee Kyong Na et al. Korean J Intern Med. 2017 Nov.

Abstract

Background/aims: The aim of this study was to compare the effects of erythromycin infusion and gastric lavage in order to improve the quality of visualization during emergency upper endoscopy.

Methods: We performed a prospective randomized pilot study. Patients presented with hematemesis or melena within 12 hours and were randomly assigned to the erythromycin group (intravenous infusion of erythromycin), gastric lavage group (nasogastric tube placement with gastric lavage), or erythromycin + gastric lavage group (both erythromycin infusion and gastric lavage). The primary outcome was satisfactory visualization. Secondary outcomes included identification of a bleeding source, the success rate of hemostasis, duration of endoscopy, complications related to erythromycin infusion or gastric lavage, number of transfused blood units, rebleeding rate, and bleeding-related mortality.

Results: A total of 43 patients were randomly assigned: 14 patients in the erythromycin group; 15 patients in the gastric lavage group; and 14 patients in the erythromycin + gastric lavage group. Overall satisfactory visualization was achieved in 81% of patients: 92.8% in the erythromycin group; 60.0% in the gastric lavage group; and 92.9% in the erythromycin + gastric lavage group, respectively (p = 0.055). The identification of a bleeding source was possible in all cases. The success rate of hemostasis, duration of endoscopy, and number of transfused blood units did not significantly differ between groups. There were no complications. Rebleeding occurred in three patients (7.0%). Bleeding-related mortality was not reported.

Conclusions: Intravenous erythromycin infusion prior to emergency endoscopy for acute nonvariceal upper gastrointestinal bleeding seems to provide satisfactory endoscopic visualization.

Keywords: Endoscopy; Erythromycin; Gastric lavage; Gastrointestinal hemorrhage.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
Flow chart of the study population. LC, liver cirrhosis.
Figure 2.
Figure 2.
Visualization score at emergency endoscopy.
See this image and copyright information in PMC

References

    1. Targownik LE, Nabalamba A. Trends in management and outcomes of acute nonvariceal upper gastrointestinal bleeding: 1993-2003. Clin Gastroenterol Hepatol. 2006;4:1459–1466. - PubMed
    1. van Leerdam ME, Vreeburg EM, Rauws EA, et al. Acute upper GI bleeding: did anything change? Time trend analysis of incidence and outcome of acute upper GI bleeding between 1993/1994 and 2000. Am J Gastroenterol. 2003;98:1494–1499. - PubMed
    1. Lassen A, Hallas J, Schaffalitzky de Muckadell OB. Complicated and uncomplicated peptic ulcers in a Danish county 1993-2002: a population-based cohort study. Am J Gastroenterol. 2006;101:945–953. - PubMed
    1. Zhao Y, Encinosa W. Rockville: Agency for Healthcare Research and Quality (US); 2006. Hospitalizations for gastrointestinal bleeding in 1998 and 2006: statistical brief #65. In: Healthcare Cost and Utilization Project, ed. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. [cited 2017 Jan 23]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK54562/ - PubMed
    1. Theocharis GJ, Thomopoulos KC, Sakellaropoulos G, Katsakoulis E, Nikolopoulou V. Changing trends in the epidemiology and clinical outcome of acute upper gastrointestinal bleeding in a defined geographical area in Greece. J Clin Gastroenterol. 2008;42:128–133. - PubMed

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