Ultrasonographic findings in ceftriaxone: associated biliary sludge and pseudolithiasis in children.
OBJECTIVE
To prospectively evaluate the incidence of biliary sludge and pseudolithiasis in children treated with ceftriaxone.


METHODS
Thirty-three children (14 girls, 19 boys) treated with ceftriaxone for prophylaxis (n=13) or for an infection (n=20) were included in this study. The incidences of biliary sludge and pseudolithiasis were investigated using ultrasonography. The ultrasonographic evaluations were performed prior to and on the 4th-5th days and on the 8th-10th days of treatment. The patients who had biliary sludge or pseudolithiasis were followed up with ultrasonographic evaluation periodically until these pathological phenomena disappeared.


RESULTS
Ceftriaxone was administrated intravenously at a dosage of 100 mg kg(-1) day(-1). Serial gallbladder sonograms were performed before treatment and on the 4th-5th and 8th-10th days of therapy. Nineteen children developed pseudolithiasis and sludge in the gallbladder, and all were asymptomatic. No significant differences were found between the patients with normal versus abnormal sonographic findings in regard to gender, age, duration of the therapy, oral restriction except the presence of surgery (P< 0.005).


CONCLUSIONS
The combination of oral restriction and surgical procedures may be a causal factor in ceftriaxone-associated biliary pseudolithiasis. It is emphasized that when gallstone and/or sludge are detected in the gallbladder in children by ultrasonographic examination, the administration of ceftriaxone must be sought beyond other causative factors.
Ozturk
A
A
Department of Radiology, Harran University Faculty of Medicine, Sanliurfa, Turkey. adilozturk21@yahoo.com
Kaya
M
M
Zeyrek
D
D
Ozturk
E
E
Kat
N
N
Ziylan
S Z
SZ
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001646:Bile / Q000000981:diagnostic imaging* / Q000187:drug effects*; D002443:Ceftriaxone / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D041761:Cholecystolithiasis / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012307:Risk Factors; D014463:Ultrasonography
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone