Safety of MiraLAX/Gatorade bowel preparation has not been established in appropriately designed studies.

摘要

Dear Editor: I commend Enestvedt et al for their meta-analysis comparing the efficacy and tolerability of different bowel preparations. This was a well-designed meta-analysis of randomized controlled trials and it clearly showed the superiority of a 4-liter split-dose (PM/AM) polyethylene glycol (PEG) for efficacy of colon cleansing vs a 4-liter PM-only dosing of 4-liter PEG. They also showed its superiority vs a 64-oz split-dose (PM/AM) of MiraLAX (Merck & Co, Whitehouse Station, NJ)/Gatorade (Pepsico, Purchase, NY). Furthermore, they noted no difference between these bowel preparations for tolerability or compliance. Based on these results, a 4-liter split-dose of PEG would appear to be the preferred bowel preparation, but 64 oz of MiraLAX/Gatorade is the preferred bowel preparation in many settings because it is perceived as better tolerated compared with the higher-volume 4-liter PEG preparation. When choosing therapies, clinicians consider efficacy, tolerability, and safety of the therapy (eg, frequency of serious adverse events). A discussion of the safety of different bowel preparations would be a helpful addition to the study by Enestvedt et al.