Transient biliary lithiasis associated with the use of ceftriaxone

Alvarez-Coca Gonzalez J, Cebrero Garcia M, Vecilla Rivelles MC, Alonso Cristobo M, Torrijos Roman C.

Servicio de Pediatria, Hospital Universitario Principe de Asturias, Alcala de Henares, Madrid, Spain.

Up to 40% of ceftriaxone is excreted unchanged into the bile and, due to its high calcium-binding affinity, it may form a salt that can provoke biliary lithiasis. Echography revealed that biliary lithiasis was present in 12-45% of patients treated with ceftriaxone as early as the second day of treatment. Lithiasis is usually asymptomatic and disappears in less than 2 months. Symptomatic cases and patients requiring cholecystectomy have been described in the literature. We present four children, evaluated in 1999, who presented asymptomatic cholelithiasis between the second and fourth day of ceftriaxone treatment. Biliary lithiasis was found after 2-4 days of treatment, with resolution of the lithiasis between 1-4 months after the end of therapy.

An Esp Pediatr. 2000 Oct;53(4):366-8.