Sonographic assessment of ceftriaxone-associated biliary pseudolithiasis in Chinese children

Area of Science:

• Pediatric Infectious Diseases
• Gastroenterology
• Pharmacology

Background:

• Ceftriaxone is a commonly used antibiotic in pediatric care.
• Biliary pseudolithiasis, or "sludge" in the gallbladder, is a potential adverse effect of certain antibiotics.
• Understanding the incidence and risk factors for ceftriaxone-associated biliary pseudolithiasis is crucial for patient safety.

Purpose of the Study:

• To evaluate the incidence and outcomes of ceftriaxone-associated biliary pseudolithiasis in Chinese children.
• To compare the risk of biliary pseudolithiasis between ceftriaxone and ceftazidime treatment groups.
• To identify the onset and resolution patterns of ceftriaxone-induced biliary precipitation.

Main Methods:

• A randomized, single-blind, case-controlled, prospective study involving 108 pediatric patients.
• Patients received either ceftriaxone or ceftazidime for hepatobiliary infection or pneumonia.
• Serial gallbladder ultrasonography was performed at multiple time points during and after therapy.

Main Results:

• Gallstones were detected in 43.10% of patients treated with ceftriaxone, compared to 2.00% in the ceftazidime group.
• The incidence of biliary pseudolithiasis was significantly higher with ceftriaxone.
• Biliary precipitation abnormalities appeared within 2-7 days, and symptoms resolved within 1-2 days after ceftriaxone discontinuation.

Conclusions:

• Ceftriaxone is associated with a significantly higher risk of biliary pseudolithiasis in Chinese children compared to ceftazidime.
• The risk of ceftriaxone-associated biliary pseudolithiasis should be a key consideration in pediatric treatment protocols.
• Prompt recognition and discontinuation of ceftriaxone can lead to rapid resolution of symptoms.