Ceftriaxone–Associated Nephrolithiasis in Children

Azita  Fesharakinia; Ali-Reza Ehsanbakhsh; Nasrin Ghorashadizadeh

IJ Pediatrics

The Scientific Journal of Growth & Development Research Center

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Ceftriaxone–Associated Nephrolithiasis in Children

Author(s):

Azita Fesharakinia^1,*,

Ali-Reza Ehsanbakhsh²,

Nasrin Ghorashadizadeh³

IJ Pediatrics:Vol. 23, issue 6; 643-647

Published online:Sep 28, 2013

Article type:Research Article

Received:Jun 07, 2013

Accepted:Aug 26, 2013

How to Cite:Azita FesharakiniaAli-Reza EhsanbakhshNasrin GhorashadizadehCeftriaxone–Associated Nephrolithiasis in Children.Iran J Pediatr.23(6):643-647.

Abstract

Objective: Ceftriaxone is a third-generation cephalosporin which is widely used for treatment of infection in children accompanied by complications like urinary tract lithiasis and gallbladder psudolithiasis or sludge. The aim of this study was to investigate the incidence and predisposing factors that contribute to these complications in children. Methods: This quasi-experimental and before- and after-study was conducted in 96 children who were hospitalized for treatment of different bacterial infections and received 50-100 mg/kg/day ceftriaxone divided into two equal doses intravenously under conditions of adequate hydration. Sonographic examinations of urinary tract and gallbladder were carried out before and after treatment for that purpose. Patients with positive sonographic findings after treatment were followed with serial sonographic examinations. Findings: Post-treatment sonography demonstrated nephrolithiasis in 6 (6.3%) and gallbladder stone in one (1%), all were asymptomatic. Comparison of the groups with and without nephrolithiasis demonstrated no significant differences with respect to age, body weight, diagnosis, season of hospitalization, dosage of drug and the duration of treatment. Nephrolithiasis had a significant relation with male gender (P=0.02). Conclusion: Our results showed that pediatric patients may develop small sized, asymptomatic renal stones during a 2-6 day course of normal or moderate dose of ceftriaxone therapy. Close monitoring of ceftriaxone treated patients especially on high dose long term therapy for nephrolithiasis and gallbladder psudolithiasis or sludge is recommended.

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