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[Ceftriaxone-induced cholelithiasis--a harmless side-effect?]
M Riccabona1, R Kerbl, W Schwinger
1Univ. Kinderklinik Graz.
Insights
Ceftriaxone treatment in children can cause gallbladder stones (cholelithiasis) in nearly half of cases, sometimes leading to jaundice or pain. Monitoring gallbladder health during and after ceftriaxone therapy is recommended.
Area of Science:
- Pediatric Infectious Diseases
- Gastroenterology
- Pharmacology
Background:
- Ceftriaxone is a common antibiotic for pediatric infections.
- Ceftriaxone-induced cholelithiasis (gallbladder stones) is a known but infrequently reported side effect.
- A case of jaundice due to ceftriaxone-induced cholelithiasis prompted this investigation.
Purpose of the Study:
- To prospectively evaluate the frequency of ceftriaxone-induced cholelithiasis in children.
- To assess the clinical sequelae of this condition.
Main Methods:
- Prospective study of 43 children treated with ceftriaxone for at least 10 days.
- Sonographical examination of the gallbladder to detect cholelithiasis and sludge.
- Clinical assessment for symptoms like abdominal pain and jaundice.
Main Results:
- 46.5% of children developed sonographical evidence of ceftriaxone-induced cholelithiasis.
- 2 children had intrahepatic cholestasis, and 3 experienced severe abdominal pain.
- 11.6% had gallbladder sludge; all cases resolved spontaneously within 2 months.
Conclusions:
- Ceftriaxone-induced cholelithiasis is common in children, occurring in nearly half of those treated for extended periods.
- The condition is typically asymptomatic or self-limiting, but monitoring is advised.
- Sonographical screening at the end of ceftriaxone treatment may aid in early detection and management.
Abstract:
43 children suffering from borreliosis, meningitis and septicemia were treated with ceftriaxone. A six year old boy with acute jaundice due to ceftriaxone induced cholelithiasis encouraged us to reevaluate the frequency of ceftriaxone induced cholelithiasis and its' sequelae in children in a prospective study. Out of 43 children (age 6.3 years, 4 months to 16 years, male: female 25:18), 20 children (46.5%) showed sonographical evidence for ceftriaxone induced cholelithiasis after a treatment of at least 10 days. Two of them even had signs of intrahepatic cholestasis, 3 kids suffered from severe abdominal pain, non of them showed serologic abnormalities. Another 5 children (11.6%) had sludge in the gallbladder without evidence for cholelithiasis. In all patients the "pseudocholelithiasis" spontaneously resolved within at most 2 months. We suggest a sonographical examination of the gallbladder at the end of the ceftriaxone treatment in order to detect cholelithiasis, which might call for further monitoring and maybe dietary treatment.