Gallbladder and urinary tract precipitations associated with ceftriaxone therapy in children: a prospective study

• Published in: Annals of tropical paediatrics Vol. 24; no. 1; pp. 25 - 31
• Main Authors: Acun, Ceyda, Erdem, L. Oktay, Söğüt, Ayhan, Erdem, C. Zuhal, Tomaç, Nazan, Gündoğdu, Sadi, Çavuldak, Şerafettin
• Format: Journal Article
• Language: English
• Published: Leeds Taylor & Francis 01.03.2004; Maney; Taylor & Francis Ltd
• Subjects: Adolescent; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - adverse effects; Bacterial Infections - drug therapy; Biological and medical sciences; Calculi - chemically induced; Calculi - diagnostic imaging; Ceftriaxone - administration & dosage; Ceftriaxone - adverse effects; Child; Child, Preschool; Female; Gallbladder Diseases - chemically induced; Gallbladder Diseases - diagnostic imaging; General aspects; Humans; Infant; Infusions, Intravenous; Lithiasis - chemically induced; Lithiasis - diagnostic imaging; Male; Medical sciences; Prospective Studies; Time Factors; Ultrasonography; Urologic Diseases - chemically induced; Urologic Diseases - diagnostic imaging; Asia; Turkey; Human; Urinary system disease; Toxicity; β-Lactams; Ceftriaxone; Urinary tract; Prospective; Cephalosporin derivatives; Antibiotic; Treatment; Lithiasis; Digestive diseases; Tropical medicine; Gallbladder; Antibacterial agent; Child
• ISSN: 0272-4936; 2046-9047; 1465-3281; 2046-9055
• DOI: 10.1179/027249304225013349

The incidence and outcome of gallbladder and urinary tract complications in children receiving ceftriaxone therapy were evaluated prospectively. The subjects were given intravenous ceftriaxone, 100 mg/kg/day, in two divided doses infused over 20-30-minute periods, for 5-14 days. Serial abdominal ultrasonography revealed gallbladder and urinary tract precipitations in five of 35 children, three of whom had gallbladder pseudolithiasis, one gallbladder sludge and one gallbladder pseudolithiasis and urinary bladder sludge. The children who had gallbladder sludge and gallbladder pseudolithiasis with urinary bladder sludge had abdominal pain, nausea and vomiting. Three children remained symptom-free. The gallbladder precipitations were found after 4-9 days of ceftriaxone therapy, and resolved completely 7-19 days after the end of treatment. The urinary tract precipitation was found on the 5th day after cessation of ceftriaxone therapy and resolved 7 days later. Ceftriaxone-associated gallbladder pseudolithiasis, gallbladder sludge and urinary bladder sludge usually resolve spontaneously and physicians should be aware of these complications so as to avoid unnecessary therapeutic procedures.