Ceftriaxone-associated biliary sludge and pseudocholelithiasis during childhood: a prospective study.
BACKGROUND
Cholelithiasis is a rare condition seen during childhood. The aim of this study was to determine frequency of biliary sludge and cholelithiasis with ceftriaxone therapy.


METHODS
Thirty-eight children aged between 1 month and 17 years were evaluated with ultrasonographic examination at the initiation of the ceftriaxone therapy and 10th day of therapy, consecutively. If biliary sludge or cholelithiasis were demonstrated, scans were repeated monthly until pathology disappeared.


RESULTS
Abnormal gallbladder sonograms were demonstrated in 36.8% (n = 14) of patients at the 10th day of therapy. Cholelithiasis was detected in 28.9% (n = 11) of patients and biliary sludge was detected in 7.9% (n = 3). Two children still had cholelithiasis at the 30th day after therapy and one had cholelithiasis after the 60th day. The 9-year-old girl who still had cholelithiasis after 60 days of therapy also had nausea, vomiting and abdominal pain at 7 days after cessation of therapy. Her 90th day sonographic examination was normal.


CONCLUSIONS
Reversible biliary sludge or pseudocholelithiasis due to ceftriaxone treatment is not a rare condition. Therefore it is benign, spontaneously resolved and clinical signs are usually absent.
Bor
Ozcan
O
Department of Pediatrics and Radiology, Faculty of Medicine, Osmangazi University, Meselik, Eskisehir, Turkey.
Dinleyici
Ener Cagri
EC
Kebapci
Mahmut
M
Aydogdu
Sultan Durmus
SD
D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001646:Bile; D002443:Ceftriaxone / Q000009:adverse effects* / Q000627:therapeutic use; D002675:Child, Preschool; D002769:Cholelithiasis / Q000139:chemically induced* / Q000000981:diagnostic imaging; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013997:Time Factors; D014463:Ultrasonography
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone