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Reversible ceftriaxone-associated biliary pseudolithiasis in children
U B Schaad1, J Wedgwood-Krucko, H Tschaeppeler
1Department of Paediatrics, University of Berne, Switzerland.
Insights
Ceftriaxone treatment in children can cause gallstones, leading to symptoms in some cases. Discontinuing the antibiotic typically resolves these biliary abnormalities and associated symptoms.
Area of Science:
- Pediatric Medicine
- Pharmacology
- Radiology
Background:
- Ceftriaxone is a widely used antibiotic for serious infections in children.
- Biliary complications are a potential, though not fully understood, side effect of ceftriaxone therapy.
Purpose of the Study:
- To investigate the incidence and clinical significance of biliary concrements in pediatric patients receiving ceftriaxone.
- To assess the reversibility of ceftriaxone-induced biliary abnormalities.
Main Methods:
- Serial abdominal ultrasonography was conducted on 37 children undergoing treatment with ceftriaxone.
- Clinical symptoms and ultrasound findings were monitored throughout and after treatment cessation.
Main Results:
- Biliary concrements were detected in 16 out of 37 pediatric patients (43%).
- Three patients experienced symptomatic biliary concrements, with one case complicated by urolithiasis and obstructive ureteropyelectasia.
- Ultrasound abnormalities and symptoms resolved completely after discontinuing ceftriaxone, with resolution times ranging from 2 to 63 days.
Conclusions:
- Ceftriaxone therapy is associated with a significant incidence of biliary concrement formation in children.
- These biliary abnormalities are generally reversible upon cessation of the antibiotic.
- Close monitoring for biliary complications may be warranted in pediatric patients on long-term ceftriaxone treatment.
Abstract:
Serial abdominal ultrasonography was performed in 37 children being treated with ceftriaxone for serious infections. Biliary concrements developed in 16 patients, causing symptoms in 3, one of whom also had urolithiasis with renal colic and obstructive ureteropyelectasia. After cessation of ceftriaxone treatment, ultrasound abnormalities and symptoms gradually disappeared, with complete sonographic resolution after 2 to 63 days.