Ceftriaxone associated nephrolithiasis: a prospective study in 284 children

Area of Science:

• Pediatric Nephrology
• Infectious Diseases
• Pharmacology

Background:

• Urinary tract calculi are a significant cause of hospital admissions in children.
• Medications are recognized etiologic factors for nephrolithiasis.
• Ceftriaxone, a common antibiotic, has rare reported associations with kidney stones.

Purpose of the Study:

• To evaluate the incidence of nephrolithiasis as a complication of ceftriaxone therapy in pediatric patients.
• To assess the safety and necessity of continued ceftriaxone use in this population.

Main Methods:

• A quasi-experimental, before-and-after study involving 284 pediatric patients with pyelonephritis.
• Patients received 75 mg/kg intravenous ceftriaxone.
• Renal ultrasonography was performed at admission, end of treatment, and 3 months post-treatment for complicated cases.

Main Results:

• No renal stones were detected on initial ultrasonography.
• Nephrolithiasis was identified in 1.4% of patients by the end of ceftriaxone treatment.
• No underlying metabolic risk factors were found in stone-forming patients, and stones resolved spontaneously post-treatment.

Conclusions:

• Ceftriaxone treatment is associated with a potential increased risk of kidney stone formation in children.
• The effective use of ceftriaxone can be safely continued, with spontaneous stone passage observed.
• Close monitoring for nephrolithiasis in pediatric patients receiving ceftriaxone is recommended.