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Ceftriaxone-induced pancreatitis in a pediatric patient: case report

S Ruggiero1, R DI Nardo, T Polimeno

  • 1Department of Experimental Medicine, Section of Pharmacology Leonardo Donatelli, Center of Pharmacosurveillance and Pharmacoepidemiology, Faculty of Medicine and Surgery, Second University of Naples, Italy. sruggy@libero.it

Journal of Chemotherapy (Florence, Italy)
|March 16, 2010
PubMed

Insights

This case report details the first probable instance of ceftriaxone-induced pancreatitis in a child. Prompt cessation of the antibiotic led to symptom improvement, highlighting a potential adverse drug reaction.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Pharmacology
  • Drug Safety

Background:

  • Ceftriaxone is a widely used third-generation cephalosporin antibiotic in pediatric practice.
  • Pancreatitis is a known, albeit rare, adverse effect associated with various medications.
  • Identifying drug-induced pancreatitis is crucial for timely diagnosis and management in children.

Observation:

  • A 2-year-old child developed symptoms including fever, vomiting, and diarrhea, and was treated with intramuscular ceftriaxone.
  • Following ceftriaxone administration, elevated amylase levels were observed, accompanied by abdominal distension and pain.
  • Further increases in amylase and lipase levels were noted after discontinuation, with gradual symptom resolution over three days.

Findings:

  • Biochemical, clinical, and instrumental parameters, along with established criteria for drug-induced pancreas disorders, supported the diagnosis.
  • The Naranjo adverse drug reaction probability scale indicated a probable link between ceftriaxone and the pancreatitis.
  • This represents the first reported case of probable primary ceftriaxone-induced pancreatitis in a pediatric patient.

Implications:

  • This case underscores the importance of considering ceftriaxone as a potential cause of pancreatitis in children presenting with compatible symptoms.
  • Clinicians should maintain a high index of suspicion for drug-induced pancreatitis when using ceftriaxone, especially in young patients.
  • Further research may be warranted to elucidate the mechanisms and incidence of ceftriaxone-induced pancreatitis in pediatric populations.

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