[Gallstones in association with the use of ceftriaxone in children]. / Cálculos biliares asociados al uso de ceftriaxona en niños.

ABSTRACT

INTRODUCTION: Ceftriaxone associated pseudolithiasis is fairly frequent in children, but rarely taken into account. It occurs in 15% to 57% of children, and in most cases is asymptomatic and resolves spontaneously. PATIENTS AND METHODS: A prospective, observational, and descriptive study was conducted that included patients aged 1 month to 18 years-old who received ceftriaxone. Liver and gallbladder ultrasound was performed at the start of treatment, and every 5 days until it was completed. Patients with abnormal ultrasound findings were followed up clinically every week until they were resolved. The findings were compared with risk factors described in the literature. RESULTS: A total of 73 patients aged between 4 months and 17 years (mean=4.2 years) were included, of whom 57.5% were female. Pseudolithiasis was present in 31 patients (42.5%) and was documented in 96.8% (n=30) of this group on day 5. The stone size was between 4 and 14mm (mean=8.1mm). The duration of pseudolithiasis was between 9 and 55 days (mean=24.1 days). Symptoms were present in 22.6% (n=7) and 1 had a serious complication. In the multivariate analysis, Ringer's Lactate as fluid dilution was 1.86 times higher risk (P=.019). No relationship was found with age, duration and dose of antibiotic, fasting, use of calcium supplements, parenteral nutrition, or use of other antibiotics. CONCLUSION: Pseudocolelitiasis associated with ceftriaxone take place in 4 of 10 children who receive, unrelated to traditional risk factors. The trend is towards self resolution although about 20% have symptoms.