DOI: https://doi.org/10.22141/2224-0551.12.5.2017.109273

Cephalosporin-induced biliary sludge in children

A.E. Abaturov, V.L. Babich, A.E. Lykova, A.E. Kozachkovsky, N.M. Lybenko

Abstract


Background. One of the side effects of the third generation cephalosporins is the formation of cephalosporin-induced biliary pseudolithiasis (CIBPL). The purpose of the study was to establish the peculiarities of the formation of biliary sludge during the application of the third generation cephalosporins in the treatment of acute respiratory infections in children. Materials and methods. We examined 46 children aged 2 to 15 years with acute respiratory infections. Сephalosporins were administered intravenously in age doses. We evaluated the biochemical blood test and the echosonography (ultrasound) of the biliary tract before the treatment and after the end of antibiotic therapy of all children. Results. According to ultrasound data, in 10 patients (21.7 %) with acute respiratory infections, after a course of therapy with the third generation cephalosporins, heterogeneous contents were detected in the gallbladder lumen in the form of a hyperechoic suspension, which indicated the formation of CIBPL. The average age of patients with CIBPL was 9.05 ± 1.44 years and was within the range of 4 to 15 years. We found that in 60 % of the examined children, the formation of CIBPL proceeded subclinically. The results of a biochemical study of blood serum showed that in children with CIBPL, an increase in the activity of alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase was observed. It was found that CIBPL is detected in 22.9 % of children against the background of ceftriaxone therapy, in 9 % of patients — ceftazidime. Biliary sludge was formed in 54.5 % of patients receiving ceftriaxone in high doses
(100 mg/kg/day), and in 75 % of cases after 10 days of using this antibiotic. Conclusions. The obtained results showed that against the background of using third generation cephalosporins in the treatment of acute respiratory infections, 21.7 % of children had CIBPL. A particularly high risk of developing CIBPL is observed when using high doses of ceftriaxone and prolonged therapy with cephalosporins.


Keywords


сephalosporins; biliary sludge; biliary pseudolithiasis; children

References


Abaturov AE, Zavhorodnia NYu. Cephalosporin-associated biliary pseudolithiasis in children. Zdorov'ye Rebenka. 2017;12(2):152-7. (In Russian). doi: 10.22141/2224-0551.12.2.2017.99772.

Volosovets AP, Yulish EI. Racional'naja antibiotikoterapija respiratornyh zabolevanij u detej [Rational antibiotic therapy of respiratory diseases in children]. Donetsk: Regina; 2005. 389 p. (In Russian).

Haitovich NV. Cephalosporins in the treatment of respiratory diseases in the outpatient clinic practice of a pediatrician. Zdorov’ye Rebenka. 2013;1.44:141-5. (In Russian). doi: 10.22141/2224-0551.1.44.2013.86564.

Lezhenko GА, Pashkova EE. The substantiation of rational antibiotic therapy of bacterial respiratory diseases in children. Zdorov'ye Rebenka. 2016;70(2):33-8. (In Russian). doi: 10.22141/2224-0551.2.70.2016.73805.

Zaffiri L, Gardner J, Toledo-Pereyra LH. History of antibiotics. From salvarsan to cephalosporins. J Invert Surg. 2012;25(2):67-77. doi: 10.3109/08941939.2012.664099.

Biner B, Oner N, Celtik C, Bostancioğlu M, Tunçbilek N, Güzel A, et al. Ceftriaxone-associated biliary pseudolithiasis in children. J Clin Ultrasound. 2006;34(5):217-28. doi: 10.1002/jcu.20228.

Choi YY, Jung YH, Choi SM, Lee CS, Kim D, Hur KY. Gallbladder pseudolithiasis caused by ceftriaxone in young adult. J Korean Surg Soc. 2011;81(6):423-6. doi: 10.4174/jkss.2011.81.6.423.

Murata S, Aomatsu T, Yoden A, Tamai H. Fasting and bed rest, even for a relatively short period, are risk factors for ceftriaxone-associated pseudolitiasis. Pediatr Int. 2015;57(5):942-6. doi: 10.1111/ped.12625.

Rodríguez Rangel DA, Pinilla Orejarena AP, Bustacara Diaz M et al. Gallstones in association with the use of ceftriaxone in children. Ann Pediatr (Barc). 2014;80(2):77-80. (In Spanish). doi: 10.1016/j.anpedi.2013.04.001.

Ustyol L, Bulut MD, Agengin K, et al. Comparative evaluation of ceftriaxone- and cefotaxime-induced biliary pseudolithiasis or nephrolithiasis: A prospective study in 154 children. Hum Exp Toxicol. 2017 Jun;36(6):547-553. pii: 0960327116658108. doi: 10.1177/0960327116658108.

Meng D, Cao Y, Fu J, et al. Sonographic assessment of ceftriaxone-associated pseudolithiasis in Chinese children. J Int Med Res. 2010;38(6):2004-10. doi: 10.1177/147323001003800614.

Nayak A, Slivka A. Ceftriaxone-Induced Gallstones: Case Report and Literature Review. ACG Case Rep J. 2014;1(3):170-2. doi: 10.14309/crj.2014.40.

Serdaroglu F, Koca YS, Saltik F, et al. Gallstones in childhood: etiology, clinical features, and prognosis. Eur J Gastroenterol Hepatol. 2016;28(12):1468-72. doi: 10.1097/MEG.0000000000000726.

Tuna Kirsaclioglu C, Çuhaci Çakir B, Bayram G, et al. Risk factors, complications and outcome of cholelithiasis in children: A retrospective, single-centre review. J Paediatr Child Health. 2016;52(10):944-9. doi: 10.1111/jpc.13235.

Oh TH, Lee YC, Yang HK. Ceftriaxone-Induced Gallstone. Clinical Ultrasound. 2016;1(2):111-4. doi: 10.18525/cu.2016.1.2.111.

Park HZ, Lee SP, Schy AL. Ceftriaxone-associated gallbladder sludge. Identification of calcium-ceftriaxone salt as a major component of gallbladder precipitate. Gastroenterology. 1991;100(6):1665-70. PMID: 2019372.




Copyright (c) 2017 CHILD`S HEALTH

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2018

 

   Seo анализ сайта