title: Sonographic assessment of ceftriaxone-associated biliary pseudolithiasis in children.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Pediatrics, University of Istanbul, Istanbul Faculty of Medicine, Capa 34390, Istanbul, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Palanduz
authors.forename: I
authors.initials: I
authors.lastname: Yalçin
authors.forename: E
authors.initials: E
authors.lastname: Tonguç
authors.forename: N
authors.initials: N
authors.lastname: Güler
authors.forename: U
authors.initials: U
authors.lastname: Oneş
authors.forename: N
authors.initials: N
authors.lastname: Salman
authors.forename: A
authors.initials: A
authors.lastname: Somer
mesh_terms: D000293:Adolescent; D002443:Ceftriaxone / Q000009:adverse effects*; D011232:Chemical Precipitation; D002648:Child; D002675:Child, Preschool; D002769:Cholelithiasis / Q000139:chemically induced* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012075:Remission, Spontaneous; D014463:Ultrasonography
chemical_list: D002443:Ceftriaxone