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Gastroenterology Research and Practice
Volume 2018, Article ID 1671483, 8 pages
https://doi.org/10.1155/2018/1671483
Review Article

Erythromycin for Promoting the Postpyloric Placement of Feeding Tubes: A Systematic Review and Meta-Analysis

1Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
2Department of Emergency Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China

Correspondence should be addressed to Jian Shi; nc.ude.umms@8002naijihs and Bin Shi; nc.ude.umms@5037nibihs

Received 5 November 2017; Revised 15 January 2018; Accepted 10 February 2018; Published 3 April 2018

Academic Editor: Per Hellström

Copyright © 2018 Qing-Jun Jiang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Critically ill patients can benefit from enteral nutrition with postpyloric feeding tubes, but the low success rate limits its wide use. Erythromycin could elevate the success rate of tube insertion, but its clinical efficiency still remains controversial. Methods. Included studies must be RCTs which assessed the success rate of postpyloric feeding tube insertion using erythromycin. Results. 284 patients were enrolled in six studies. Meta-analysis showed that erythromycin significantly increases the rate of successful postpyloric feeding tube placement (RR 1.45, 95% CI (1.12, 1.86)) and did not increase the risk of adverse effects (RR 2.15, 95% CI (0.20, 22.82)). Subgroup analysis showed that unweighted feeding tubes (RR 1.47, 95% CI (1.03, 2.11)) could significantly increase the success rate. Country of study, intravenous route of erythromycin, and year of participant enrollment did not influence these results. Conclusions. Erythromycin significantly increases the success rate of postpyloric feeding tube placement. This suggests that erythromycin can be used as an auxiliary method to improve the success rate of bedside insertion.