Related Experiment Video
Updated: May 10, 2026
Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291
Published on: December 10, 2016
[Gallstones in association with the use of ceftriaxone in children]
D A Rodríguez Rangel1, A P Pinilla Orejarena2, M Bustacara Diaz3
1Clínica Materno Infantil San Luis, Bucaramanga, Colombia.
Insights
Ceftriaxone frequently causes gallbladder pseudolithiasis in children, affecting nearly 43% of patients. While usually asymptomatic and self-resolving, Ringer's Lactate use increases risk. This condition requires careful monitoring in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Pharmacology
- Diagnostic Imaging
Context:
- Ceftriaxone-associated pseudolithiasis is a common, often overlooked, finding in children.
- It affects a significant percentage of pediatric patients, typically resolving spontaneously.
Purpose:
- To prospectively investigate the incidence, characteristics, and risk factors of ceftriaxone-induced pseudolithiasis in children.
- To compare findings with existing literature on risk factors.
Summary:
- A study of 73 children (1 month-18 years) receiving ceftriaxone found pseudolithiasis in 42.5% (31 patients), often by day 5.
- Mean stone size was 8.1mm, duration 24.1 days, with 22.6% symptomatic. Ringer's Lactate dilution was a significant risk factor (P=.019).
- No association was found with age, antibiotic dose/duration, fasting, calcium, parenteral nutrition, or other antibiotics.
Impact:
- Highlights the high prevalence of ceftriaxone-induced pseudolithiasis in pediatric populations.
- Identifies Ringer's Lactate as a potential risk factor, guiding clinical practice.
- Emphasizes the need for awareness and monitoring, despite the generally benign and self-limiting nature of the condition.
Introduction:
Ceftriaxone associated pseudolithiasis is fairly frequent in children, but rarely taken into account. It occurs in 15% to 57% of children, and in most cases is asymptomatic and resolves spontaneously.
Patients And Methods:
A prospective, observational, and descriptive study was conducted that included patients aged 1 month to 18 years-old who received ceftriaxone. Liver and gallbladder ultrasound was performed at the start of treatment, and every 5 days until it was completed. Patients with abnormal ultrasound findings were followed up clinically every week until they were resolved. The findings were compared with risk factors described in the literature.
Results:
A total of 73 patients aged between 4 months and 17 years (mean=4.2 years) were included, of whom 57.5% were female. Pseudolithiasis was present in 31 patients (42.5%) and was documented in 96.8% (n=30) of this group on day 5. The stone size was between 4 and 14mm (mean=8.1mm). The duration of pseudolithiasis was between 9 and 55 days (mean=24.1 days). Symptoms were present in 22.6% (n=7) and 1 had a serious complication. In the multivariate analysis, Ringer's Lactate as fluid dilution was 1.86 times higher risk (P=.019). No relationship was found with age, duration and dose of antibiotic, fasting, use of calcium supplements, parenteral nutrition, or use of other antibiotics.
Conclusion:
Pseudocolelitiasis associated with ceftriaxone take place in 4 of 10 children who receive, unrelated to traditional risk factors. The trend is towards self resolution although about 20% have symptoms.
Related Concept Videos
01:28Inhibitors of Bacterial DNA Synthesis
01:20Cholecystitis
01:30Urinary Tract Calculi III: Medical Management
01:18Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention
01:28Acute Pyelonephritis II: Diagnostic Studies and Management