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[Ceftriaxone-induced cholelithiasis]
M Maccherini1, G Borlini, M Branchi
1Divisione di Pediatria, Ospedale Civile di Sondrio, Italia.
Insights
Ceftriaxone can cause biliary sludge and gallstones, especially in children. Stopping the antibiotic often resolves the issue, suggesting cautious use is warranted.
Area of Science:
- Pediatric Gastroenterology
- Pharmacology
- Hepatobiliary Medicine
Background:
- Ceftriaxone is a widely used antibiotic in pediatric care.
- Biliary sludge and cholelithiasis are known potential side effects of ceftriaxone.
- This adverse effect is underrecognized in gastroenterology and surgical literature.
Observation:
- Two pediatric cases of ceftriaxone-induced cholelithiasis are presented.
- Biliary sludge formation occurred following ceftriaxone administration.
- Symptoms in affected patients necessitated intervention.
Findings:
- Discontinuation of ceftriaxone led to prompt resolution of biliary sludge in reported cases.
- Cholecystectomy was performed in symptomatic patients, despite potential for drug cessation to resolve the condition.
- The incidence and clinical significance of ceftriaxone-induced gallstones in children may be underestimated.
Implications:
- Ceftriaxone should be prescribed with greater caution in pediatric populations due to the risk of cholelithiasis.
- Increased awareness among clinicians is needed to recognize and manage this adverse drug effect.
- Further research into the mechanisms and prevalence of ceftriaxone-induced gallstones is recommended.
Abstract:
The formation of biliary sludge and cholelithiasis after ceftriaxone administration is not uncommon. Prompt resolution of sludge has been demonstrated with discontinuation of the drug. Despite this, cholecystectomy has been performed in symptomatic patients. Ceftriaxone is popular drug in pediatrics, but the complication is not widely appreciated in the gastroenterology and surgical literature. For this adverse effect and for cost ceftriaxone should be used with more caution. We describe two cases of children with ceftriaxone induced cholelithiasis.