Pharmacological treatment of ceftriaxone-related cholelithiasis in children: Is it worthwhile?

Anna Maria Oggiano, Maria Grazia Clemente, Laura Cuzzolin, Cristian Locci, Claudia Maria Piredda, Kathleen Schwarz, Roberto Antonucci

Research output: Contribution to journalArticle

Abstract

Ceftriaxone treatment of bacterial infections can be associated with biliary complications, more commonly in children than adults, in a dosedependent manner. This study describes a clinical case series of children with ceftriaxone-related cholelithiasis. We performed a retrospective analysis of cases of ceftriaxone-related biliary complications admitted to the Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Sassari, Italy, during the period 2005-2015. Four children with cholelithiasis occurring during, or soon after, the treatment with ceftriaxone are reported. Case 1 (6-month-old), case 2 (9-yearold) and case 4 (10-year-old) were symptomatic, while case 3 (3-year-old) was asymptomatic. After the ultrasonographic diagnosis of gallstones (cases 1 and 2) or biliary sludge (cases 3 and 4), ceftriaxone treatment was withdrawn, and ursodeoxycholic acid (UDCA) was started in cases 1 and 2. A complete recovery was observed in all but case 1, in whom cholelithiasis was still detectable at one-year follow-up by ultrasonography. This case underwent a triple antibiotic protocol for bacterial meningitis. The protocol included rifampicin, which is known to have an effect in decreasing hepatic concentration of bile salts. Therefore, in this case, both rifampicin and UDCA were of no benefit in preventing or treating ceftriaxone biliary complications. The current pharmacological approach for the treatment of ceftriaxonerelated cholelithiasis seems to be ineffective, likely due to the high calcium content of gallstones. Therefore, the best strategy of intervention for ceftriaxone biliary complications in children remains the prevention of the risk factors.

Original languageEnglish (US)
Article numbere080108
JournalJournal of Pediatric and Neonatal Individualized Medicine
Volume8
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Cholelithiasis
Ceftriaxone
Pharmacology
Ursodeoxycholic Acid
Gallstones
Rifampin
Therapeutics
Bacterial Meningitides
Clinical Medicine
Bile Acids and Salts
Bacterial Infections
Bile
Italy
Biomedical Research
Ultrasonography
Pediatrics
Anti-Bacterial Agents
Calcium
Liver

Keywords

  • Biliary sludge
  • Children
  • Gallstones
  • Pseudo-cholelithiasis
  • Rifampicin
  • Ursodeoxycholic acid

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Pharmacological treatment of ceftriaxone-related cholelithiasis in children : Is it worthwhile? / Oggiano, Anna Maria; Clemente, Maria Grazia; Cuzzolin, Laura; Locci, Cristian; Piredda, Claudia Maria; Schwarz, Kathleen; Antonucci, Roberto.

In: Journal of Pediatric and Neonatal Individualized Medicine, Vol. 8, No. 1, e080108, 01.01.2019.

Research output: Contribution to journalArticle

Oggiano, Anna Maria ; Clemente, Maria Grazia ; Cuzzolin, Laura ; Locci, Cristian ; Piredda, Claudia Maria ; Schwarz, Kathleen ; Antonucci, Roberto. / Pharmacological treatment of ceftriaxone-related cholelithiasis in children : Is it worthwhile?. In: Journal of Pediatric and Neonatal Individualized Medicine. 2019 ; Vol. 8, No. 1.
@article{68644705906540ba9ebe80436e4e8c9f,
title = "Pharmacological treatment of ceftriaxone-related cholelithiasis in children: Is it worthwhile?",
abstract = "Ceftriaxone treatment of bacterial infections can be associated with biliary complications, more commonly in children than adults, in a dosedependent manner. This study describes a clinical case series of children with ceftriaxone-related cholelithiasis. We performed a retrospective analysis of cases of ceftriaxone-related biliary complications admitted to the Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Sassari, Italy, during the period 2005-2015. Four children with cholelithiasis occurring during, or soon after, the treatment with ceftriaxone are reported. Case 1 (6-month-old), case 2 (9-yearold) and case 4 (10-year-old) were symptomatic, while case 3 (3-year-old) was asymptomatic. After the ultrasonographic diagnosis of gallstones (cases 1 and 2) or biliary sludge (cases 3 and 4), ceftriaxone treatment was withdrawn, and ursodeoxycholic acid (UDCA) was started in cases 1 and 2. A complete recovery was observed in all but case 1, in whom cholelithiasis was still detectable at one-year follow-up by ultrasonography. This case underwent a triple antibiotic protocol for bacterial meningitis. The protocol included rifampicin, which is known to have an effect in decreasing hepatic concentration of bile salts. Therefore, in this case, both rifampicin and UDCA were of no benefit in preventing or treating ceftriaxone biliary complications. The current pharmacological approach for the treatment of ceftriaxonerelated cholelithiasis seems to be ineffective, likely due to the high calcium content of gallstones. Therefore, the best strategy of intervention for ceftriaxone biliary complications in children remains the prevention of the risk factors.",
keywords = "Biliary sludge, Children, Gallstones, Pseudo-cholelithiasis, Rifampicin, Ursodeoxycholic acid",
author = "Oggiano, {Anna Maria} and Clemente, {Maria Grazia} and Laura Cuzzolin and Cristian Locci and Piredda, {Claudia Maria} and Kathleen Schwarz and Roberto Antonucci",
year = "2019",
month = "1",
day = "1",
doi = "10.7363/080108",
language = "English (US)",
volume = "8",
journal = "Journal of Pediatric and Neonatal Individualized Medicine",
issn = "2281-0692",
publisher = "Hygeia Press di Corridori Marinella",
number = "1",

}

TY - JOUR

T1 - Pharmacological treatment of ceftriaxone-related cholelithiasis in children

T2 - Is it worthwhile?

AU - Oggiano, Anna Maria

AU - Clemente, Maria Grazia

AU - Cuzzolin, Laura

AU - Locci, Cristian

AU - Piredda, Claudia Maria

AU - Schwarz, Kathleen

AU - Antonucci, Roberto

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Ceftriaxone treatment of bacterial infections can be associated with biliary complications, more commonly in children than adults, in a dosedependent manner. This study describes a clinical case series of children with ceftriaxone-related cholelithiasis. We performed a retrospective analysis of cases of ceftriaxone-related biliary complications admitted to the Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Sassari, Italy, during the period 2005-2015. Four children with cholelithiasis occurring during, or soon after, the treatment with ceftriaxone are reported. Case 1 (6-month-old), case 2 (9-yearold) and case 4 (10-year-old) were symptomatic, while case 3 (3-year-old) was asymptomatic. After the ultrasonographic diagnosis of gallstones (cases 1 and 2) or biliary sludge (cases 3 and 4), ceftriaxone treatment was withdrawn, and ursodeoxycholic acid (UDCA) was started in cases 1 and 2. A complete recovery was observed in all but case 1, in whom cholelithiasis was still detectable at one-year follow-up by ultrasonography. This case underwent a triple antibiotic protocol for bacterial meningitis. The protocol included rifampicin, which is known to have an effect in decreasing hepatic concentration of bile salts. Therefore, in this case, both rifampicin and UDCA were of no benefit in preventing or treating ceftriaxone biliary complications. The current pharmacological approach for the treatment of ceftriaxonerelated cholelithiasis seems to be ineffective, likely due to the high calcium content of gallstones. Therefore, the best strategy of intervention for ceftriaxone biliary complications in children remains the prevention of the risk factors.

AB - Ceftriaxone treatment of bacterial infections can be associated with biliary complications, more commonly in children than adults, in a dosedependent manner. This study describes a clinical case series of children with ceftriaxone-related cholelithiasis. We performed a retrospective analysis of cases of ceftriaxone-related biliary complications admitted to the Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Sassari, Italy, during the period 2005-2015. Four children with cholelithiasis occurring during, or soon after, the treatment with ceftriaxone are reported. Case 1 (6-month-old), case 2 (9-yearold) and case 4 (10-year-old) were symptomatic, while case 3 (3-year-old) was asymptomatic. After the ultrasonographic diagnosis of gallstones (cases 1 and 2) or biliary sludge (cases 3 and 4), ceftriaxone treatment was withdrawn, and ursodeoxycholic acid (UDCA) was started in cases 1 and 2. A complete recovery was observed in all but case 1, in whom cholelithiasis was still detectable at one-year follow-up by ultrasonography. This case underwent a triple antibiotic protocol for bacterial meningitis. The protocol included rifampicin, which is known to have an effect in decreasing hepatic concentration of bile salts. Therefore, in this case, both rifampicin and UDCA were of no benefit in preventing or treating ceftriaxone biliary complications. The current pharmacological approach for the treatment of ceftriaxonerelated cholelithiasis seems to be ineffective, likely due to the high calcium content of gallstones. Therefore, the best strategy of intervention for ceftriaxone biliary complications in children remains the prevention of the risk factors.

KW - Biliary sludge

KW - Children

KW - Gallstones

KW - Pseudo-cholelithiasis

KW - Rifampicin

KW - Ursodeoxycholic acid

UR - http://www.scopus.com/inward/record.url?scp=85063299643&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85063299643&partnerID=8YFLogxK

U2 - 10.7363/080108

DO - 10.7363/080108

M3 - Article

AN - SCOPUS:85063299643

VL - 8

JO - Journal of Pediatric and Neonatal Individualized Medicine

JF - Journal of Pediatric and Neonatal Individualized Medicine

SN - 2281-0692

IS - 1

M1 - e080108

ER -