Ceftriaxone-induced lithiasis

Abstract

Introduction: Lithiasis associated with ceftriaxone has been recognized since 1988, and although most are asymptomatic, symptoms and even complications may occur.

Objective: To determine the incidence of vesicular and renal lithiasis in children treated with this antibiotic with doses of 75-100 mg/kg/day, considered normal.

Methods: Prospective longitudinal observational study in patients admitted to the Nephrology Department of "William Soler" University Pediatric Hospital due to an infectious process and who received treatment with ceftriaxone. The following variables were measured: age (years), sex, infectious processes, dose (mg/kg/day), route and time (days) of treatment with ceftriaxone, type of lithiasis and urinary tract abnormalities.

Results: In the renal and hepatobiliary ultrasonographic study, renal lithiasic alteration was detected in 8 patients (9.5 %); in 7 (8.3%) it was biliary and in 2 (2.4%). One patient developed both types of lithiasis. Kidney stones were small in size (2 to 3 mm) and biliary alterations ranged from biliary mud to larger lithiasis (17 mm). The ultrasonographic alterations disappeared spontaneously between 7 and 32 days after the discontinuation of treatment.

Conclusions: Lithiasic complications associated with ceftriaxone are more frequent in the hepatobiliary system than in the urinary tract, most of the time they are asymptomatic, they can occur with normal doses of the antibiotic whether administered intravenously or intramuscularly without exceeding a week of treatment, and tend to disappear spontaneously in a short time.