Effect of oral clarithromycin on gall-bladder motility in normal subjects and those with gall-stones.

Summary Background Motilin receptor stimulation with erythromycin has been shown to have a prokinetic effect on gall-bladder motility in human beings. Aim To find out whether oral clarithromycin has similar prokinetic activity to erythromycin on fasting and postprandial gall-bladder emptying in normal humans and those with gall-stone disease. Methods In a blinded two-way crossover study clarithromycin 500 mg and a placebo were administered to 10 normal subjects and 10 subjects with gall-stone disease. Gall-bladder volumes were assessed in the fasting and postprandial state. Results Fasting volumes were significantly less following clarithromycin administration in both normal subjects and subjects with gall-stones compared with placebo (12.1 ± 1.8 mL vs. 17.8 ± 2.0 mL, P < 0.05 and 16.7 ± 2 mL vs. 26.8 ± 7.2 mL, P < 0.02, mean ± S.E.M). Postprandial volumes were also significantly less following clarithromycin administration. Ejection fraction significantly increased following clarithromycin in both normal subjects (66 ± 5.8% vs. 37 ± 5.9%, P = 0.02) and subjects with gall-stones (45 ± 3.2 vs. 20 ± 1.6%, P < 0.02). Conclusion Clarithromycin enhances both fasting and postprandial gall-bladder contraction in normal humans and also in those with gall-stone disease.