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Ultrasonographic findings in ceftriaxone: associated biliary sludge and pseudolithiasis in children
1Department of Radiology, Harran University Faculty of Medicine, Sanliurfa, Turkey. adilozturk21@yahoo.com
Insights
This study found that ceftriaxone treatment in children can lead to asymptomatic biliary sludge and pseudolithiasis. Surgery and oral restriction may increase the risk of these ceftriaxone-associated gallbladder issues.
Area of Science:
- Pediatric Gastroenterology
- Pharmacology
- Medical Imaging
Background:
- Ceftriaxone is a commonly used antibiotic in pediatric care.
- Biliary sludge and pseudolithiasis are potential adverse effects of certain medications.
- Understanding the incidence and risk factors for these conditions is crucial for patient safety.
Purpose of the Study:
- To determine the occurrence of biliary sludge and pseudolithiasis in children receiving ceftriaxone.
- To identify potential contributing factors to ceftriaxone-associated gallbladder abnormalities.
Main Methods:
- A prospective study involving 33 children treated with ceftriaxone.
- Ultrasonography was used to assess gallbladder status before, during, and after treatment.
- Follow-up ultrasonography was performed for patients with detected abnormalities.
Main Results:
- Nineteen children (57.6%) developed asymptomatic biliary pseudolithiasis and sludge.
- No significant differences were observed based on gender, age, or therapy duration.
- Surgery was a significant factor associated with abnormal sonographic findings (P<0.005).
Conclusions:
- Ceftriaxone can cause biliary pseudolithiasis and sludge in children, often without symptoms.
- Oral restriction and surgical procedures may be risk factors for these adverse events.
- Clinicians should consider ceftriaxone use when biliary abnormalities are detected in pediatric patients.
Purpose:
To prospectively evaluate the incidence of biliary sludge and pseudolithiasis in children treated with ceftriaxone.
Material And Methods:
Thirty-three children (14 girls, 19 boys) treated with ceftriaxone for prophylaxis (n=13) or for an infection (n=20) were included in this study. The incidences of biliary sludge and pseudolithiasis were investigated using ultrasonography. The ultrasonographic evaluations were performed prior to and on the 4th-5th days and on the 8th-10th days of treatment. The patients who had biliary sludge or pseudolithiasis were followed up with ultrasonographic evaluation periodically until these pathological phenomena disappeared.
Results:
Ceftriaxone was administrated intravenously at a dosage of 100 mg kg(-1) day(-1). Serial gallbladder sonograms were performed before treatment and on the 4th-5th and 8th-10th days of therapy. Nineteen children developed pseudolithiasis and sludge in the gallbladder, and all were asymptomatic. No significant differences were found between the patients with normal versus abnormal sonographic findings in regard to gender, age, duration of the therapy, oral restriction except the presence of surgery (P< 0.005).
Conclusion:
The combination of oral restriction and surgical procedures may be a causal factor in ceftriaxone-associated biliary pseudolithiasis. It is emphasized that when gallstone and/or sludge are detected in the gallbladder in children by ultrasonographic examination, the administration of ceftriaxone must be sought beyond other causative factors.
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