Acute urine retention induced by ceftriaxone

Area of Science:

• Pharmacology
• Nephrology
• Pediatrics

Background:

• Ceftriaxone is a third-generation cephalosporin antibiotic with known adverse effects including biliary pseudolithiasis and nephrolithiasis.
• Fatal calcifications have been reported in neonates receiving ceftriaxone with intravenous calcium.
• The exact mechanisms behind ceftriaxone-induced stone formation remain unclear.

Observation:

• This report details a pediatric case of acute urinary retention (AUR) developing on the second day of ceftriaxone therapy.
• Elevated urinary uric acid excretion was noted in the affected child.
• A paternal family history of gout and kidney stones was identified retrospectively.

Findings:

• Ceftriaxone therapy can precipitate acute urinary retention in susceptible individuals.
• Elevated uric acid excretion may be a contributing factor in ceftriaxone-associated urolithiasis.
• A family history of gout or nephrolithiasis increases the risk of AUR or urolithiasis during ceftriaxone treatment.

Implications:

• Clinicians should consider ceftriaxone as a potential cause of AUR, especially in children with a relevant family history.
• Monitoring for urinary symptoms and performing urinalysis to detect crystalluria is crucial for early diagnosis and management.
• Identifying at-risk patients and monitoring for crystalluria can help avoid extensive investigations and interventions for ceftriaxone-induced urinary complications.