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Ceftriaxone Administration Associated with Lithiasis in Children: Guilty or Not? A Systematic Review
Aspasia Louta1, Aimilia Kanellopoulou2, Loukia Alexopoulou Prounia2
1Second Department of Surgery-Intensive Care Unit and Endoscopy Unit, Aretaieion University Hospital, 11528 Athens, Greece.
Insights
Ceftriaxone use in children can cause lithiasis (stones) in the bile and urinary systems. Risk factors like dose and duration are noted, but more research is needed to confirm the exact association.
Area of Science:
- Pediatric Nephrology
- Pediatric Gastroenterology
- Pharmacology
Background:
- Lithiasis is a recognized adverse effect of ceftriaxone in pediatric patients.
- Several factors, including sex, age, weight, dosage, and duration of intake, have been implicated as potential risk factors for ceftriaxone-induced lithiasis.
Purpose of the Study:
- To systematically review the effects of ceftriaxone administration in hospitalized pediatric patients.
- To investigate the incidence of gallstones, nephroliths, and precipitations in biliary and urinary systems.
- To explore potential relationships with maternal pregnancy history.
Main Methods:
- A systematic review of original studies and literature reviews from the PubMed database.
- Inclusion of articles without time restrictions.
- Evaluation of outcomes and predisposing factors for ceftriaxone-related lithiasis.
Main Results:
- 33 out of 181 initially found articles were included in the review.
- Variability in ceftriaxone dosage was observed across studies.
- Symptoms like abdominal pain and vomiting were frequently associated with ceftriaxone-related lithiasis.
Conclusions:
- Most findings are based on retrospective observations, highlighting a need for prospective, randomized studies.
- Further randomized controlled trials with long-term follow-up are essential to establish a definitive link between ceftriaxone and pediatric lithiasis.
Abstract:
Lithiasis is a known side effect of ceftriaxone administration in children. Sex, age, weight, dosage, and duration of intake have been reported as risk factors for the formation of calcification or stones in the bile and urine excretory systems of children who received ceftriaxone. The purpose of this systematic review is to investigate the reported effects of ceftriaxone administration in pediatric patients who were admitted to a hospital due to infection, the likelihood of gallstones, nephroliths, or precipitations in both the biliary and urinary systems, as well as investigate the relationship with their mother's history during pregnancy. Original studies and literature reviews from the PubMed database were included in the study. No time limit related to research or publication was set for the articles. The results were evaluated, aiming to understand the outcomes and identify any predisposing factors relevant to this side effect. Of the 181 found articles, 33 were appropriate for inclusion in the systematic review. The administered dose of ceftriaxone presented variability. Symptoms, such as abdominal pain and vomiting, were associated with ceftriaxone-related lithiasis in many cases. It was noted that most of the results were the outcomes of retrospective observation and not of prospective randomized research. Definitively, more randomized control studies with long-term outcomes are needed to identify the exact association between ceftriaxone and lithiasis in children.
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