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Several macrolide antibiotics such as erythromycin and azithromycin have motilin receptor agonistic effects, and have a stimulatory effect on gastric emptying rate (100102)

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However, this effect was not observed in channel catfish 17 , rainbow trout 18 and hybrid tilapia 19

This reduction may result from thymic atrophy secondary to malnutrition or hormonal imbalances commonly observed in these patients