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Ceftriaxone-induced pseudolithiasis in children treated for perforated appendicitis.

AbstractPURPOSE:
Ceftriaxone has been associated with development of pseudolithiasis. In our institution, it is used for treatment of perforated appendicitis in children. This study evaluated the occurrence of ceftriaxone-related pseudolithiasis in this population.
METHODS:
After obtaining IRB approval, we performed a retrospective chart review over 51 months. We included patients undergoing laparoscopic appendectomy for perforated appendicitis. All patients were treated with ceftriaxone post-operatively. Patients without initial or post-treatment gallbladder imaging available for review were excluded.
RESULTS:
There were 71 patients who met inclusion criteria with a mean (±SD) age of 10.8 ± 3.8 years. Of these, 14 % (n = 10) developed stones or sludge in the gallbladder. The mean duration of ceftriaxone therapy was 8.7 ± 3.8 days. The average time to post-antibiotic imaging was 11.5 ± 10.3 days from initiation of antibiotics. There was no significant difference in duration of ceftriaxone therapy in the children that developed pseudolithiasis or sludge (10.0 ± 4.9 days) compared to those that did not (8.5 ± 3.6, p = 0.26). One child (10 %) with pseudolithiasis went on to become symptomatic, requiring a laparoscopic cholecystectomy.
CONCLUSIONS:
In our experience, ceftriaxone use for perforated appendicitis is associated with a significant incidence of biliary pseudolithiasis, and is unrelated to duration of ceftriaxone therapy.
AuthorsHanna Alemayehu, Amita A Desai, Priscilla Thomas, Susan W Sharp, Shawn D St Peter
JournalPediatric surgery international (Pediatr Surg Int) Vol. 30 Issue 3 Pg. 323-6 (Mar 2014) ISSN: 1437-9813 [Electronic] Germany
PMID24464035 (Publication Type: Journal Article)
Chemical References
  • Anti-Bacterial Agents
  • Ceftriaxone
Topics
  • Anti-Bacterial Agents (adverse effects, therapeutic use)
  • Appendicitis (drug therapy, surgery)
  • Ceftriaxone (adverse effects, therapeutic use)
  • Child
  • Cholelithiasis (chemically induced)
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Retrospective Studies
  • Time Factors

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