Any news from the prokinetic front?

Curr Opin Crit Care. 2019 Aug;25(4):349-355. doi: 10.1097/MCC.0000000000000634.


Purpose of review: This review provides an update of recently conducted studies and randomized controlled trials evaluating prokinetic drugs.

Recent findings: Prokinetic drugs accelerate gastric emptying and, particularly in patients with gastric dysmotility and enteral feed intolerance, their use increases the delivery of enteral nutrition. However, prokinetic drugs have not been shown to improve patient-centered outcomes in trials but benefit is assumed on the basis of observational studies, which report close associations between gastric dysmotility, enteral feed intolerance and poor outcomes, and improvement in surrogate physiological outcomes when prokinetic drugs are administered.

Summary: It may not be feasible to establish superiority of a prokinetic drug within a randomized controlled trial with a patient-centered event as the primary outcome. The use of metoclopramide and erythromycin as prokinetic drugs is based on observations from trials measuring surrogate physiological outcomes. Randomized controlled trials of alternative drug regimens and novel prokinetic drugs have recently been completed and results outlined.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Enteral Nutrition
  • Erythromycin / therapeutic use*
  • Gastric Emptying / drug effects*
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Metoclopramide / therapeutic use*
  • Observational Studies as Topic
  • Randomized Controlled Trials as Topic
  • Treatment Outcome


  • Gastrointestinal Agents
  • Erythromycin
  • Metoclopramide