The Turkish Journal of Pediatrics 2007; 49: 404-407 Original Biliary precipitation during ceftriaxone therapy: frequency and risk factors

Ceftriaxone, a third-generation cephalosporin, is widely used for treating infection during childhood. It is mainly eliminated in the urine, but approximately 40 % of a given dose is unmetabolized and secreted into bile. The aim of this study was to investigate the frequency, clinical characteristics, and outcome of biliary sludge (BS) in addition to potential contributing risk factors in children who receive ceftriaxone. Biliary ultrasonography was performed at the time of randomization before ceftriaxone treatment was started, on the 5th and 10th days, and at the end of the treatment. If BS was detected, patients were followed-up weekly by sonographic examination until the BS or biliary lithiasis (BL) disappeared. A total of 114 children (56 girls, 58 boys; age range: 2-180 months, mean 47.5±46.3 mos) were enrolled in the study. Fourteen (12%) subjects developed BS and 10 (9%) developed BL on the 5th day of treatment. On the 10th day of treatment, 20 (18%) subjects developed BS and 15 (13%) developed BL. In total, 35 (31%) of all subjects developed biliary precipitation (BP)