Sonographic assessment of ceftriaxone-associated biliary pseudolithiasis in children

✍ Scribed by Palanduz, Ay?e; Yal�?n, I??k; Tongu�, Erdem; G�ler, Nermin; �ne?, �lker; Salman, Nuran; Somer, Ayper

• Publisher: John Wiley and Sons
• Year: 2000
• Tongue: English
• Weight: 121 KB
• Volume: 28
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/(sici)1097-0096(200005)28:4<166::aid-jcu2>3.0.co;2-g

✦ Synopsis

Purpose. Ceftriaxone is a widely used third-generation cephalosporin. In this prospective study, we used sonography to investigate the incidence and outcome of biliary complications in children receiving ceftriaxone therapy.

Methods. Ceftriaxone was administered intravenously at a dosage of 100 mg/kg/day for 1-3 weeks to 118 children hospitalized for severe infection. Serial gallbladder sonograms were obtained on days 1, 5-7, and 10-14 of therapy and the day after therapy ended if it had lasted more than 2 weeks. When sonographic abnormalities were found, additional sonograms were obtained every 3 days until the abnormalities had completely resolved.

Results. Twenty patients (17%), all asymptomatic, demonstrated sonographic abnormalities: 8 had gallbladder sludge, defined as echogenic material without associated acoustic shadowing, and 12 had pseudolithiasis, defined as echogenic material with acoustic shadowing. These abnormalities spontaneously resolved within 2 weeks of stopping the ceftriaxone (mean time to disappearance, 8.2 ± 3.4 days). No significant differences were found between patients with normal versus abnormal sonographic findings in sex, age, duration of treatment, or other risk factors for drug precipitation.

Conclusions. Ceftriaxone-associated biliary pseudolithiasis is usually asymptomatic and was rapidly reversible after cessation of therapy in this group of Turkish children.