Ceftriaxone‐associated biliary pseudolithiasis in children: do we know enough?

Abstract

Ceftriaxone is an antibiotic agent frequently used in paediatric hospital practice for the treatment of severe bacterial infections. The use of this agent can result in cholelithiasis and/or biliary sludge, more commonly in children than in adults. This systematic review was aimed at analysing available literature concerning ceftriaxone‐associated biliary pseudolithiasis in paediatric patients, with a special emphasis on the clinical aspects. A literature analysis was performed using Medline and Embase electronic databases (articles published in English up to December 2019), with the search terms and combinations as follows:’ceftriaxone’, ‘cholelithiasis’, ‘biliary sludge’ ‘gallstones’ ‘neonates’ ‘children’ ‘clinical aspects’ ‘management’. Several case reports, case series and prospective/retrospective studies have documented a relationship between ceftriaxone treatment and biliary pseudolithiasis in the paediatric population, even though literature data regarding neonates and infants are scarce. Ceftriaxone‐associated biliary pseudolithiasis is dose‐dependent and usually asymptomatic but, sometimes, it may present with abdominal pain, nausea and emesis. Abdominal ultrasonography should be performed when this complication is suspected. Generally, ceftriaxone‐associated cholelithiasis resolves over a variable period of time (days to months) after cessation of therapy. Therefore, a conservative approach to this condition is advocated, but a prolonged follow‐up may be necessary. A personalized assessment of factors predisposing to ceftriaxone‐associated biliary pseudolithiasis before prescribing the drug can allow to minimize the risk of developing it, with significant advantages in terms of human and economic costs.

Ceftriaxone-Induced Gallbladder Stones in Children

“…In our three cases, only one risk factor, which was noticed in our case, is a high dose of ceftriaxone along with a prolonged duration of more than three weeks to four months. Palanduz, et al [11] reported in their study that 118 children were admitted to hospital for severe infection and received intravenous ceftriaxone at a dose of 100 mg/kg /day for three weeks. On days one, seven, and fourteen, an ultrasound abdomen was performed at regular intervals to monitor the adverse effects of ceftriaxone.…”

Relationship between cholelithiasis and metabolic syndrome: the role of genetic factors

“…В качестве примера можно привести цефтриаксон-ассоциированный билиарный псевдолитиаз у детей. После применения цефтриаксона в течение некоторого продолжительного периода у 17% детей возможно сгущение желчи в виде осадка желчного пузыря без акустической тени по данным ультразвукового метода исследования органов брюшной полости [5]. Восстановление сонографической картины желчного пузыря и реологии желчи происходит после отмены цефтриаксона в течение нескольких недель.…”

Biliary pseudolithiasis in an older patient treated with lascufloxacin

“…2 Most reports of pseudolithiasis involve high doses of the drug being administered to children. 3 There are still few reports of pseudolithiasis in older adults. 4 We herein report an older patient in whom biliary pseudolithiasis occurred as a result of administering a loading dose of lascufloxacin (LSFX).…”

“…It is also used to treat stress incontinence in the elderly. [1][2][3] In Japan, the press-through-package (PTP) sheets and the shape of the tablets of clenbuterol hydrochloride resemble those of galantamine. Hence, elderly patients with dementia and stress incontinence can mistake one drug for the other or mix them up, which could result in drug poisoning.…”