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Related Experiment Videos

Ceftriaxone-associated biliary pseudolithiasis in children.

Betül Biner1, Naci Oner, Coşkun Celtik

  • 1Department of Pediatrics, Trakya University Faculty of Medicine, Cocuk Sağliği ve Hastaliklari AD 22030 Edirne, Turkey.

Journal of Clinical Ultrasound : JCU
|May 5, 2006
PubMed
Summary

High doses of ceftriaxone can cause reversible gallbladder and urinary tract pseudolithiasis in children. This side effect is usually asymptomatic and resolves after treatment cessation.

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Area of Science:

  • Pediatric Pharmacology
  • Diagnostic Imaging
  • Adverse Drug Reactions

Background:

  • Ceftriaxone is a commonly used antibiotic in pediatric care.
  • The drug is known to cause reversible precipitations in the gallbladder and urinary tract, termed pseudolithiasis.
  • Understanding the incidence and risk factors for ceftriaxone-induced pseudolithiasis is crucial for patient management.

Purpose of the Study:

  • To determine the incidence of gallbladder and urinary tract pseudolithiasis in children treated with ceftriaxone.
  • To identify predisposing factors associated with the development of ceftriaxone-induced pseudolithiasis.

Main Methods:

  • A prospective study involving 156 children treated with varying daily doses of ceftriaxone (50, 75, 100 mg/kg).
  • Sonographic examinations of the gallbladder and urinary tract were conducted at multiple time points: pre-treatment, day 3, day 7, and at 1 and 2 months post-treatment.

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  • Patients with positive findings were monitored weekly until resolution.

    • Main Results:

    • Ceftriaxone-induced pseudolithiasis was observed in 17% of children (27/156).
    • Gallbladder abnormalities included lithiasis (10%) and sludge (7%). Urolithiasis occurred in 0.6% of patients.
    • Pseudolithiasis was more common in older children and those receiving higher ceftriaxone doses (P < 0.01 and P < 0.05).

    Conclusions:

    • Biliary pseudolithiasis, and less commonly nephrolithiasis, frequently occurs in pediatric patients receiving high-dose ceftriaxone.
    • The condition is typically asymptomatic and reversible, resolving within approximately 16 days after drug discontinuation.
    • Clinicians should be aware of this reversible complication and avoid unnecessary surgical interventions like cholecystectomy when symptoms arise.