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Gallbladder and urinary tract precipitations associated with ceftriaxone therapy in children: a prospective study
Ceyda Acun1, L Oktay Erdem, Ayhan Söğüt
1Department of Pediatrics, Faculty of Medicine, Karaelmas University, Zonguldak, Turkey. ceydaacun@hotmail.com
Insights
Ceftriaxone therapy in children can cause gallbladder and urinary tract issues like pseudolithiasis and sludge. These complications typically resolve on their own after treatment cessation.
Area of Science:
- Pediatric Medicine
- Pharmacology
- Radiology
Background:
- Ceftriaxone is a widely used antibiotic in pediatric care.
- Gallbladder and urinary tract complications are potential adverse effects of ceftriaxone.
- Prospective evaluation is needed to understand the incidence and outcomes of these complications.
Purpose of the Study:
- To prospectively evaluate the incidence and outcomes of gallbladder and urinary tract complications in children treated with ceftriaxone.
- To identify the specific types of complications, such as pseudolithiasis and sludge.
- To determine the resolution patterns of these ceftriaxone-associated findings.
Main Methods:
- Prospective study involving children receiving intravenous ceftriaxone (100 mg/kg/day for 5-14 days).
- Serial abdominal ultrasonography was performed to monitor for gallbladder and urinary tract precipitations.
- Clinical symptoms and resolution times were recorded.
Main Results:
- Five out of 35 children (14.3%) developed gallbladder and/or urinary tract precipitations.
- Complications included gallbladder pseudolithiasis, gallbladder sludge, and urinary bladder sludge.
- Symptomatic children experienced abdominal pain, nausea, and vomiting; asymptomatic cases also occurred.
- Gallbladder precipitations resolved within 7-19 days after treatment cessation.
- Urinary tract precipitation resolved within 7 days after detection post-treatment.
Conclusions:
- Ceftriaxone can lead to gallbladder pseudolithiasis, gallbladder sludge, and urinary bladder sludge in children.
- These complications are generally self-limiting and resolve spontaneously after discontinuation of ceftriaxone.
- Awareness of these potential adverse effects is crucial for clinicians to avoid unnecessary interventions.
Abstract:
The incidence and outcome of gallbladder and urinary tract complications in children receiving ceftriaxone therapy were evaluated prospectively. The subjects were given intravenous ceftriaxone, 100 mg/kg/day, in two divided doses infused over 20-30-minute periods, for 5-14 days. Serial abdominal ultrasonography revealed gallbladder and urinary tract precipitations in five of 35 children, three of whom had gallbladder pseudolithiasis, one gallbladder sludge and one gallbladder pseudolithiasis and urinary bladder sludge. The children who had gallbladder sludge and gallbladder pseudolithiasis with urinary bladder sludge had abdominal pain, nausea and vomiting. Three children remained symptom-free. The gallbladder precipitations were found after 4-9 days of ceftriaxone therapy, and resolved completely 7-19 days after the end of treatment. The urinary tract precipitation was found on the 5th day after cessation of ceftriaxone therapy and resolved 7 days later. Ceftriaxone-associated gallbladder pseudolithiasis, gallbladder sludge and urinary bladder sludge usually resolve spontaneously and physicians should be aware of these complications so as to avoid unnecessary therapeutic procedures.
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