title: Comparative evaluation of ceftriaxone- and cefotaxime-induced biliary pseudolithiasis or nephrolithiasis: A prospective study in 154 children.
abstract: BACKGROUND
  Biliary lithiasis, or sludge, and nephrolithiasis have been reported as a possible complication of ceftriaxone therapy. However, no study related to cefotaxime-induced biliary pseudolithiasis or nephrolithiasis was observed in the literature. Therefore, we investigated the comparative formation of biliary pseudolithiasis and nephrolithiasis after cefotaxime and ceftriaxone therapies.
  
  
  METHODS
  The patients treated with ceftriaxone or cefotaxime were enrolled during the study period. Ultrasound imaging of the biliary and urinary tract was performed in all patients before and after the treatment. The patients with a positive sonographic finding at the end of treatment were followed up with monthly ultrasonography for 3 months.
  
  
  RESULTS
  The present study showed that abnormal biliary sonographic findings were demonstrated in 18 children (20.9%) treated with ceftriaxone, 13 (15.1%) had biliary lithiasis, 5 (5.8%) had biliary sludge and 1 (1.2%) had nephrolithiasis. Abnormal biliary sonographic findings were demonstrated in only four (5.9%) children treated with cefotaxime who had biliary sludge and only one (1.5%) had nephrolithiasis. It was observed that older age was at significantly higher risk of developing biliary sludge or stone formation. Receiver operating characteristic analysis was performed to determine the residual risk and analysis found that 4.5 years was the cut-off value for age.
  
  
  CONCLUSIONS
  The present study is unique in the literature for reporting for the first time gall bladder sludge and nephrolithiasis associated with cefotaxime use. Therefore, patients treated with cefotaxime should be monitored for serious complications like patients treated with ceftriaxone. Nevertheless, if third-generation cephalosporin is used, cefotaxime is recommended to be used rather than ceftriaxone.
authors.affiliation: 1 Department of Pediatric Nephrology, Yuzuncuyıl University, Van, Turkey.
authors.forename: L
authors.initials: L
authors.lastname: Ustyol
authors.affiliation: 2 Department of Radiology, Yuzuncuyıl University, Van, Turkey.
authors.forename: M D
authors.initials: MD
authors.lastname: Bulut
authors.affiliation: 3 Department of Pediatric Surgery, Yuzuncuyıl University, Van, Turkey.
authors.forename: K
authors.initials: K
authors.lastname: Agengin
authors.affiliation: 4 Department of Pediatrics, Yuzuncuyıl University, Van, Turkey.
authors.forename: K A
authors.initials: KA
authors.lastname: Bala
authors.affiliation: 2 Department of Radiology, Yuzuncuyıl University, Van, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Yavuz
authors.affiliation: 2 Department of Radiology, Yuzuncuyıl University, Van, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Bora
authors.affiliation: 5 Department of Pediatric Gastroenterology, Sevket Yılmaz Goverment Hospital, Bursa, Turkey.
authors.forename: K
authors.initials: K
authors.lastname: Demiroren
authors.affiliation: 4 Department of Pediatrics, Yuzuncuyıl University, Van, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Dogan
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001646:Bile / Q000187:drug effects*; D002439:Cefotaxime / Q000009:adverse effects*; D002443:Ceftriaxone / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020347:Lithiasis / Q000139:chemically induced* / Q000000981:diagnostic imaging; D008297:Male; D053040:Nephrolithiasis / Q000139:chemically induced* / Q000000981:diagnostic imaging; D014463:Ultrasonography
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D002439:Cefotaxime
keywords: Ceftriaxone; biliary pseudolithiasis; cefotaxime; nephrolithiasis