| A Prospective Study on Ceftriaxone-associated Biliary Pseudolithiasis : A Dose-related Comparison |
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Sun Ju Lee1, Jun Ho Kim1, Jin Hwa Jeong1, Sung Min Cho1, Sung Tae Park2, Dae Seob Choi2, Hyeon Kyeong Lee2 |
1Department of Pediatrics, College of Medicine, Dongguk University Pohang Hospital, Pohang, Korea
2Department of Radiology, College of Medicine, Dongguk University Pohang Hospital, Pohang, Korea |
| Ceftriaxone 유발 가담석증 발생에 관한 전향적 연구: 투여 용량과 관련된 비교 |
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이선주1, 김준호1, 정진화1, 조성민1, 박성태2, 최대섭2, 이현경2 |
1동국대학교 의과대학 소아과학교실
2동국대학교 의과대학 방사선과학교실 |
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| Abstract |
Purpose
: Ceftriaxone, a parenteral third-generation cephalosporine, is widely used in the treatment of various bacterial infections. It possesses high calcium-binding affinity, forming complexes with calcium in bile salts to develop precipitate that mimics gallstone on ultrasonography. Biliary pseudolithiasis resolves completely with cessation of therapy, but several symptomatic patients have undergone cholesystectomy. We prospectively evaluated the incidence, risk factors and dose- related comparison with ultrasonography.
Methods
: Between November 1998 and August 1999, 81 cases of inpatients on ceftriaxone treatment in Dongguk University Pohang Hospital were enrolled for this study. They were divided according to dose of ceftriaxone, high-dose and low-dose groups. Repeated sonography was performed on 1, 3, 5 and 7 days after initiation of ceftriaxone treatment and then weekly until pseudolithiasis were resolved.
Results
: Thirty-eight percent of the subjects acquired pseudolithiasis. Sonographic abnormalities appeared from 1 to 10 days after ceftriaxone therapy and completely resolved from 1 to 24 days after cessation of ceftriaxone therapy. The incidence of pseudolithiasis was significantly higher in the high-dose group(P<0.001). In the high-dose group, fasting over a day was a significant risk factor of pseudolithiasis(P<0.01). Sex, age, duration of ceftriaxone therapy, laboratory findings, type of infection or chief complaint were not significant risk factors for pseudolithiasis.
Conclusion
: We suggest that abdominal ultrasonography should be considered in all children who receive high dose ceftriaxone with fasting over a day. If pseudolithiasis was developed, we can detect the most of resolution after 30 days of cessation of therapy. |
| Key Words:
Biliary pseudolithiasis, Ceftriaxone, Dose-related |
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