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The direct effect of erythromycin on gastrointestinal motility was studied; it was found to have a stimulatory effect proximally, on stomach and duodenal motility, with an apparent distal inhibition. Gastric emptying was accelerated by erythromycin via an antroduodenal coordination mechanism, an effect that has proved to be beneficial in surgical and medical conditions in which gastroparesis is a problem. Erythromycin is now used experimentally and clinically; it has been found to accelerate gastric as well as gallbladder emptying and to have an effect on the oesophagus. Analogues of erythromycin have been developed that have potent gastrointestinal activity but little or no antibacterial potential. Macrolides modulate the antibacterial action of neutrophils, with some action on the oxidative burst. Finally, two new macrolide immunosuppressants have been developed that compare favourably with traditional drugs.<\/jats:p>","DOI":"10.1002\/bjs.1800811006","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T19:50:59Z","timestamp":1172951459000},"page":"1423-1429","source":"Crossref","is-referenced-by-count":23,"title":["Macrolides in roles beyond antibiotic therapy"],"prefix":"10.1093","volume":"81","author":[{"given":"M-A","family":"Pilot","sequence":"first","affiliation":[{"name":"Surgical and Gastrointestinal Science Units, The London Hospital Medical College , London E1 2AJ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1994,10,1]]},"reference":[{"key":"2024092813172198600_bib1","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1128\/AAC.33.9.1419","article-title":"New directions for macrolide antibiotics: pharmacokinetics and clinical efficacy","volume":"33","author":"Kirst","year":"1989","journal-title":"Antimicrob Agents Chemother"},{"key":"2024092813172198600_bib2","first-page":"460","article-title":"A clinical study of erythromycin in the treatment of 47 patients","author":"Shoemaker","year":"1953\u20131954","journal-title":"Antibiotics Annual"},{"key":"2024092813172198600_bib3","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1093\/jac\/15.1.83","article-title":"Erythromycin stearate, 1\u00b75 g for the oral prophylaxis of streptococcal bacteraemia in patients undergoing dental extraction: efficacy and tolerance","volume":"15","author":"Shanson","year":"1985","journal-title":"J Antimicrob Chemother"},{"key":"2024092813172198600_bib4","doi-asserted-by":"crossref","first-page":"661","DOI":"10.3109\/00365548709117201","article-title":"Twice-a-day regimen of erythromycin base is effective in the treatment of acute streptococcal tonsillitis","volume":"19","author":"Hovi","year":"1987","journal-title":"Scand J Infect Dis"},{"key":"2024092813172198600_bib5","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1016\/S0140-6736(87)91241-4","article-title":"Erythromycin and gastrointestinal motility","volume":"ii","author":"Hughes","year":"1987","journal-title":"Lancet"},{"key":"2024092813172198600_bib6","first-page":"812","article-title":"Comparison of oral erythromycin ethylsuccinate and clavulanate-potentiated amoxycillin in the treatment of acute respiratory tract infections","volume":"11","author":"Shanks","year":"1989","journal-title":"Clin Ther"},{"key":"2024092813172198600_bib7","first-page":"750","article-title":"Clinical study of josamycin","author":"Fukushima","year":"1969","journal-title":"Progress in Antimicrobial and Anticancer Chemotherapy. 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