Ceftriaxone-induced pseudolithiasis in children treated for perforated appendicitis

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Hanna Alemayehu1, Amita A Desai, Priscilla Thomas

  • 1Department of Surgery, Center for Prospective Clinical Trials, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA.

Pediatric Surgery International
|January 28, 2014
PubMed

Insights

Ceftriaxone use in children with perforated appendicitis can lead to biliary pseudolithiasis. This condition, characterized by gallbladder stones or sludge, occurred in 14% of patients and was not linked to treatment duration.

Area of Science:

  • Pediatric Surgery
  • Pediatric Infectious Diseases
  • Gastroenterology

Background:

  • Ceftriaxone is a commonly used antibiotic in pediatric care.
  • Pseudolithiasis, or gallbladder sludge/stones, has been linked to ceftriaxone therapy.
  • Perforated appendicitis in children often requires antibiotic treatment, including ceftriaxone.

Purpose of the Study:

  • To evaluate the incidence of ceftriaxone-related pseudolithiasis in children treated for perforated appendicitis.
  • To determine if the duration of ceftriaxone therapy influences pseudolithiasis development.

Main Methods:

  • Retrospective chart review of 71 pediatric patients undergoing laparoscopic appendectomy for perforated appendicitis.
  • All patients received post-operative ceftriaxone treatment.
  • Gallbladder imaging before and after treatment was analyzed.

Main Results:

  • 14% (10 out of 71) of patients developed gallbladder stones or sludge.
  • Mean duration of ceftriaxone therapy was 8.7 days.
  • No significant difference in treatment duration was found between patients who developed pseudolithiasis and those who did not.

Conclusions:

  • Ceftriaxone treatment for perforated appendicitis in children is associated with a significant incidence of biliary pseudolithiasis.
  • The development of pseudolithiasis was not dependent on the duration of ceftriaxone therapy.
  • One case of symptomatic pseudolithiasis required cholecystectomy.
Abstract

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