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Adverse reaction to ceftriaxone in a 28-day-old infant undergoing urgent craniotomy due to epidural hematoma: review of neonatal biliary pseudolithiasis.

Bartkowska-Śniatkowska A, Jończyk-Potoczna K, Zielińska M, Rosada-Kurasińska J - Ther Clin Risk Manag (2015)

Bottom Line: Although pediatric patients rarely develop gallbladder disorders, this complication may lead to adverse events in high-risk patients with predisposing factors, particularly in neonates and infants treated with ceftriaxone.We also discuss the efficacy of ceftriaxone in neonates and infants.Neonatologists and pediatric intensivists should be aware of the higher risk of co-existence of hyperbilirubinemia and gallbladder disorders while using ceftriaxone in pediatric settings.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Anesthesiology and Intensive Therapy, Poznan University of Medical Sciences, Poznan, Poland.

ABSTRACT
The debate as to whether to administer ceftriaxone to neonates is likely to continue. Ceftriaxone has numerous advantages for critically ill pediatric patients. However, it is also known to contribute substantially to the development of biliary pseudolithiasis. Although pediatric patients rarely develop gallbladder disorders, this complication may lead to adverse events in high-risk patients with predisposing factors, particularly in neonates and infants treated with ceftriaxone. In this paper we present an interesting case report of a 28-day-old neonate with spontaneous severe epidural hematoma who developed biliary pseudolithiasis related to the use of ceftriaxone. We also discuss the efficacy of ceftriaxone in neonates and infants. Neonatologists and pediatric intensivists should be aware of the higher risk of co-existence of hyperbilirubinemia and gallbladder disorders while using ceftriaxone in pediatric settings.

No MeSH data available.


Related in: MedlinePlus

The gallbladder after 3 weeks of treatment – complete normalization of image.
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f4-tcrm-11-1035: The gallbladder after 3 weeks of treatment – complete normalization of image.

Mentions: In view of the ceftriaxone therapy, the picture of biliary sludge suggested ceftriaxone-associated pseudolithiasis. Ceftriaxone was discontinued on the following day, after a total therapy that lasted 3 days. At this time, the ursodeoxycholic acid was administered to the child at a dose of 15 mg/kg twice a day and fat-soluble vitamins as supplementary therapy. After 2 weeks of treatment, ultrasonography revealed partial and gradual improvement and no surgical intervention was required (Figure 3). Following another week, ultrasound examination showed complete normalization of image (Figure 4). There was a gradual improvement of the radiological image over the course of 3 weeks and the bilirubin remained elevated for the first 14 days, reaching a maximum level of 8.38 mg/dL. Nevertheless, due to the prolonged hyperbilirubinemia, phototherapy was also introduced for the next 3 days, but no spectacular improvement was achieved. Despite this drug-related complication, the infant’s neurological status gradually improved, and he was able to be weaned and disconnected from the ventilator. He was successfully extubated on day 12 of his stay in pediatric intensive care. The first neurological examination was made when the child was conscious (Glasgow Coma Scale score of 12 points) and revealed signs of right-handed paresis. The patient was transferred to the surgical department to continue treatment and rehabilitation.


Adverse reaction to ceftriaxone in a 28-day-old infant undergoing urgent craniotomy due to epidural hematoma: review of neonatal biliary pseudolithiasis.

Bartkowska-Śniatkowska A, Jończyk-Potoczna K, Zielińska M, Rosada-Kurasińska J - Ther Clin Risk Manag (2015)

The gallbladder after 3 weeks of treatment – complete normalization of image.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494631&req=5

f4-tcrm-11-1035: The gallbladder after 3 weeks of treatment – complete normalization of image.
Mentions: In view of the ceftriaxone therapy, the picture of biliary sludge suggested ceftriaxone-associated pseudolithiasis. Ceftriaxone was discontinued on the following day, after a total therapy that lasted 3 days. At this time, the ursodeoxycholic acid was administered to the child at a dose of 15 mg/kg twice a day and fat-soluble vitamins as supplementary therapy. After 2 weeks of treatment, ultrasonography revealed partial and gradual improvement and no surgical intervention was required (Figure 3). Following another week, ultrasound examination showed complete normalization of image (Figure 4). There was a gradual improvement of the radiological image over the course of 3 weeks and the bilirubin remained elevated for the first 14 days, reaching a maximum level of 8.38 mg/dL. Nevertheless, due to the prolonged hyperbilirubinemia, phototherapy was also introduced for the next 3 days, but no spectacular improvement was achieved. Despite this drug-related complication, the infant’s neurological status gradually improved, and he was able to be weaned and disconnected from the ventilator. He was successfully extubated on day 12 of his stay in pediatric intensive care. The first neurological examination was made when the child was conscious (Glasgow Coma Scale score of 12 points) and revealed signs of right-handed paresis. The patient was transferred to the surgical department to continue treatment and rehabilitation.

Bottom Line: Although pediatric patients rarely develop gallbladder disorders, this complication may lead to adverse events in high-risk patients with predisposing factors, particularly in neonates and infants treated with ceftriaxone.We also discuss the efficacy of ceftriaxone in neonates and infants.Neonatologists and pediatric intensivists should be aware of the higher risk of co-existence of hyperbilirubinemia and gallbladder disorders while using ceftriaxone in pediatric settings.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Anesthesiology and Intensive Therapy, Poznan University of Medical Sciences, Poznan, Poland.

ABSTRACT
The debate as to whether to administer ceftriaxone to neonates is likely to continue. Ceftriaxone has numerous advantages for critically ill pediatric patients. However, it is also known to contribute substantially to the development of biliary pseudolithiasis. Although pediatric patients rarely develop gallbladder disorders, this complication may lead to adverse events in high-risk patients with predisposing factors, particularly in neonates and infants treated with ceftriaxone. In this paper we present an interesting case report of a 28-day-old neonate with spontaneous severe epidural hematoma who developed biliary pseudolithiasis related to the use of ceftriaxone. We also discuss the efficacy of ceftriaxone in neonates and infants. Neonatologists and pediatric intensivists should be aware of the higher risk of co-existence of hyperbilirubinemia and gallbladder disorders while using ceftriaxone in pediatric settings.

No MeSH data available.


Related in: MedlinePlus