Relevance to NICE guidance programmes

Advice

This use of erythromycin is not appropriate for referral for a NICE technology appraisal and is not currently planned into any other work programme.

Erythromycin has been reviewed as a motility agent in the following clinical guidelines:

Type 2 diabetes: the management of type 2 diabetes (a partial update of CG66) (NICE clinical guideline 87) recommends considering a trial of metoclopramide, domperidone or erythromycin for an adult with gastroparesis, with referral to specialist services if the diagnosis is in doubt or there is persistent or severe vomiting.
Nutrition support in adults (NICE clinical guideline 32) recommends consideration of a motility agent for people in intensive or acute care settings who have delayed gastric emptying, are not tolerating enteral tube feeding, and who have no rectifiable pharmacological cause or suspicion of gastrointestinal obstruction. Following review of the available evidence, the full guideline concludes that erythromycin (and metoclopramide) appears to be effective in improving gastric motility and may improve tolerance to enteral feeds for a limited period, although the available studies do not provide evidence of benefit for important long-term clinical end points. Caution is recommended in the intensive care population because of potential drug interactions and adverse effects.