Abstract

CHOLECYSTOKINETIC EFFECT OF AZITHROMYCIN ON HEALTHY SUBJECTS: A PLACEBO- CONTROLLED CROSSOVER STUDY

Ugwu AC, Agwu K K,Agbasi P, *Umeh E, Imo AO, Ekezie J

ABSTRACT

Background: Impaired gallbladder motility is a precursor for gallstone formation. Cisapride and erythromycin are potent cholecystokinetic agents but their arrhythmogenic liabilities are obstacles to their use. Azithromycin is a similar to erythromycin in structure but does not have significant drug-drug interaction as seen with erythromycin. Purpose: To investigate the cholecystokinetic effect of azithromycin on healthy subjects. Methods: Real-time ultrasonography was used to assess gallbladder contraction indices (GBC1s) in 24 healthy volunteers after an overnight fast. The subjects ingested placebo and azithromycin in a cross-over method. The GBC1s were obtained with the subjects in supine position every 5 minutes for 40 minutes. Comparisons were made between placebo and azithromycin values using paried t-test with P<0.05 as a criterion for statistical significance. Results: In the first five and ten minutes, azithromycin significantly improved gallbladder motility. This increase was not sustained till the 35th minute when maximum GBC1s for the placebo was noted. Significantly higher GBC1s at the 40th minute with azithromycin might indicate a delay in gallbladder refilling or multiplicity in azithromycin’s peak period of cholecytokinetic activity. Conclusion- Azithromycin stimulates gallbladder motility and can be used as an alternative to erythromycin due to its reduced drug-drug interaction compared to erythromycin. It has a transient cholecystokinetic effect which could have a clinical utility in the removal of microlithiasis in patient on total parenteran nutrition and delayed gallbladder motility.

Keywords: Azithromycin, cholecystokinetic drug, ultrasonography, Gallbladder contraction