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Risk factors leading to ceftriaxone-associated biliary pseudolithiasis in children
1Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Medical College, Taipei, Taiwan, R.O.C.
Insights
Ceftriaxone therapy in pediatric patients may cause gallbladder precipitates. Fasting and older age (over 24 months) were identified as risk factors for this ceftriaxone-associated gallbladder abnormality.
Area of Science:
- Pediatric Gastroenterology
- Pharmacology
- Diagnostic Imaging
Background:
- Ceftriaxone is a commonly used antibiotic for bacterial infections in children.
- Gallbladder abnormalities, such as precipitates or pseudolithiasis, have been anecdotally reported with ceftriaxone therapy.
- The incidence and risk factors for these abnormalities in pediatric populations require further investigation.
Purpose of the Study:
- To prospectively evaluate the incidence of gallbladder precipitates or pseudolithiasis in pediatric patients receiving ceftriaxone therapy.
- To identify potential risk factors associated with the development of ceftriaxone-induced gallbladder abnormalities in children.
Main Methods:
- Prospective evaluation of 151 pediatric patients treated with ceftriaxone for bacterial enteritis between July 1992 and June 1994.
- Serial abdominal ultrasonography was performed to monitor gallbladder status.
- Statistical analysis was used to identify significant risk factors.
Main Results:
- Five out of 151 patients (3.3%) developed gallbladder precipitates or pseudolithiasis during ceftriaxone treatment.
- Fasting state and patient age over 24 months were identified as significant risk factors (p < 0.05).
- No significant differences were observed regarding sex, ceftriaxone dose, or duration of therapy.
Conclusions:
- Ceftriaxone therapy can lead to gallbladder precipitates or pseudolithiasis in pediatric patients.
- Fasting and older age are significant risk factors for this adverse event.
- Close monitoring of the gallbladder may be warranted in pediatric patients receiving prolonged ceftriaxone therapy, particularly those who are fasting or older than 24 months.
Abstract:
Between July, 1992 and June, 1994, 151 pediatric patients who had ceftriaxone therapy for probable or definite bacterial enteritis were prospectively evaluated by serial abdominal ultrasonography. All patients received a dose of > or = 50 mg/kg/day and for a duration of 3 or more days. Five patients developed gallbladder precipitates or pseudolithiasis during treatment. Fasting and patients older than 24 months were probably the significant risk factors associated with this phenomenon (p < 0.05). However, no significant differences in sex, dose (50 vs. > 50 mg/kg/day) or duration of therapy (< 5 vs. > 5 day) were observed between patients who received ceftriaxone with and without the development of this gallbladder abnormality.