Ceftriaxone 연관 가담석증에 대한 임상적 고찰

Abstract

Purpose: Ceftriaxone is wide used for the treatment of bacterial infections, especially empirical treatment for bacterial meningitis and also well known for its inducing biliary pseudolithiasis. Review of present datas about it shows it has a benign process, but in occasion it causes operation. In Korea, there were a few reports about its clinical characteristics and there was no convincing agreement about its risk factors. I intended this study to evaluate its incidence, risk factors, and prognosis and to help the management of patients who would be treated with ceftriaxone.

Methods: From March 2001 to October 2006, all children who admitted to the Department of Pediatrics in Yogin Severance Hospital and treated with ceftriaxone and had abdominal ultrasonograpy were included in this study. The children with history of hemolytic anemia, liver or kidney disease, ileal surgery were excluded. They were divided according to the presence of pseudolithiasis and compared with the ceftriaxone dosage, age, sex, existing infection, laboratory findings.

Results: Among 32 patients who received ceftriaxone and evaluated with abdominal ultrasonograpy, there were eight children (25%) having pseudolithiasis. The incidence of it was significantly higher in high dosage and menigitis group (P<0.05). Age, sex, laboratory finding, duration of ceftriaxone therapy did not showed statistical significance.

Conclusion: I recommend that a regular abdominal ultrasonography should be considered in the patients with high dose ceftriaxone treatment and bacterial meningitis.