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Smerat MI, Shawer B, AbuIrayyeh BM, Natsheh ST, Diab L, Shahin FB, Manasra MR. Ceftriaxone-induced symptomatic cholelithiasis in a child: case report and literature review. Oxf Med Case Reports 2024; 2024:omae062. [PMID: 38860015 PMCID: PMC11162581 DOI: 10.1093/omcr/omae062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/19/2024] [Accepted: 05/08/2024] [Indexed: 06/12/2024] Open
Abstract
Ceftriaxone is a third-generation cephalosporin. Due to its wide range of activity and acceptable safety profile, it is frequently prescribed to paediatric patients. However, there are several documented cases of reports of uncommon adverse events, such as cholecystitis, linked to the use of ceftriaxone. This study discusses the case of an 8-year-old female patient who developed cholecystitis, an inflammation of the gallbladder, after being treated with ceftriaxone. The patient presented with right upper quadrant pain, associated with nausea. Imaging studies showed the presence of stones and shadowing sludge, leading to acute inflammation of the gallbladder. Prompt cessation of ceftriaxone and supportive treatment led to the resolution of cholecystitis and the complete disappearance of the sludge and stones. The study highlights that early identification and withdrawal of the antibiotic can lead to successful therapy and the avoidance of unnecessary surgical procedures.
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Affiliation(s)
| | - Balqis Shawer
- College of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | - Bara M AbuIrayyeh
- College of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | - Shahd T Natsheh
- College of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | - Laila Diab
- College of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | - Farah B Shahin
- College of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | - Mahmoud R Manasra
- College of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
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Arpacık M, Yıldız ZA. Effect of ceftriaxone on intestinal transit time. Fundam Clin Pharmacol 2023; 37:158-162. [PMID: 36208418 DOI: 10.1111/fcp.12841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/21/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
Ceftriaxone reduces gallbladder and ileal contractility. Many studies have shown that ceftriaxone causes biliary sludge and pseudolithiasis. However, its effect on intestinal transit time has not been investigated. This study aimed to investigate the effect of ceftriaxone on intestinal transit time. Sixteen rats were examined in two groups: The study group (group A, n = 8) was administered with 100 mg/kg ceftriaxone intramuscularly for 7 days. The control group (group B, n = 8) was administered with intramuscular distilled water for 7 days. On the seventh day, a mixture of 2 ml barium and saline was given orally to both groups. Barium transit was evaluated using serial digital X-ray images. The stomach was full and the transition into the small intestine loop was observed in all rats at 45 min in both groups. At the 2nd hour, colonic transition was observed in two rats in group A (2/8, 25%) and in seven rats in group B (7/8, 87.5%). At the 4th hour, five (62.5%) rats in group A had transverse colonic transition, and all rats in group B (8/8, 100%) had transverse and/or left colonic transition. At the 6th hour, no rat in group A had rectal transition, and all rats in group B (8/8, 100%) had complete passage of colonic contrast material. Ceftriaxone significantly prolongs the small intestine transit time, large intestine transit time, and total intestinal transit times.
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Affiliation(s)
- Mehmet Arpacık
- Pediatric Surgery, Pediatric Burn Center, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Zeliha Akış Yıldız
- Pediatric Surgery, Umraniye Training and Research Hospital, Istanbul, Turkey
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E S, Srikanth MS, Shreyas A, Desai S, Mehdi S, Gangadharappa HV, Suman, Krishna KL. Recent advances, novel targets and treatments for cholelithiasis; a narrative review. Eur J Pharmacol 2021; 908:174376. [PMID: 34303667 DOI: 10.1016/j.ejphar.2021.174376] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/15/2021] [Accepted: 07/21/2021] [Indexed: 11/21/2022]
Abstract
Cholelithiasis is a common and frequent condition all over the world with a high prevalence rate in western countries. Individuals with cholesterol gallstone disease experience intense gastrointestinal symptoms and have a high risk of developing comorbidities like cholecystitis, Gall bladder (GB) cancer and pancreatitis. Multiple risk factors associated with cholesterol gallstones include but not limited to genetics, dietary habits, lifestyle changes, comorbid conditions and various drugs. These factors may lead to alteration in bile, cholesterol & phospholipids homeostasis in the GB, intestine and hepatocytes culminating in cholesterol gallstones formation. Surgical (cholecystectomy) and non-surgical (oral dissolution therapy) treatments are available for the disease, albeit with certain complications and high treatment cost. Thus, there is a need for interventions, complementary or alternative therapies for the treatment and prevention of cholesterol gallstones. Currently available drug therapies used for cholesterol gallstones include statins and ezetimibe. Many patients consider traditional herbal practitioners due to their promise of non-invasive and pain free management of gall stones. This present a positive shift towards generally acceptable safety and cost effectiveness of herbal treatment warranting extensive research for alternative or complementary choice such as herbal plants as an emerging area for their potential therapeutic effects. This review discusses current strategies, latest trends available in the disease pathogenesis, drug development for novel targets, risk management, newer anti-lithogenic drugs and herbal plants that target the different aspects of the disease.
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Affiliation(s)
- Swarne E
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, 570 015, Karnataka, India
| | - M S Srikanth
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, 570 015, Karnataka, India
| | - Ayachit Shreyas
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, 570 015, Karnataka, India
| | - Sneha Desai
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, 570 015, Karnataka, India
| | - Seema Mehdi
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, 570 015, Karnataka, India
| | - H V Gangadharappa
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, 570 015, Karnataka, India
| | - Suman
- Department of Dravya Guna, Government Ayurvedic Medical College and Hospital, New Sayyaji Rao Road, Mysuru, 570 001, India
| | - K L Krishna
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, 570 015, Karnataka, India.
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Koh KJ, Lin LH. One-year-old Boy with Gallbladder Stone: A Case Report and Literature Review. J Med Ultrasound 2021; 28:260-263. [PMID: 33659169 PMCID: PMC7869745 DOI: 10.4103/jmu.jmu_28_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/16/2020] [Accepted: 02/20/2020] [Indexed: 11/29/2022] Open
Abstract
Gallstone is a rare disease in children. It might cause complications such as cholecystitis, cholangitis, and gallstone pancreatitis due to obstruction of biliary duct or secondary infection. We report a case of a 1-year, 7-month-old boy with incidental finding of gallbladder stone, who received ceftriaxone treatment after diagnosing with Salmonella enterocolitis. Herein, we review the incidence, etiology, risk factors, and management of ceftriaxone-related gallstones in children. In conclusion, these patients are suggested to receive expectant management with close follow-up instead of surgical intervention.
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Affiliation(s)
- King Jun Koh
- Department of Pediatrics, Sijhih Cathay General Hospital, New Taipei City, Taiwan.,School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Lung Huang Lin
- School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.,Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan
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Prediction of Unbound Ceftriaxone Concentration in Children: Simple Bioanalysis Method and Basic Mathematical Equation. Antimicrob Agents Chemother 2020; 65:AAC.00779-20. [PMID: 33020163 DOI: 10.1128/aac.00779-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 10/01/2020] [Indexed: 01/29/2023] Open
Abstract
The pharmacological activity of ceftriaxone depends on the unbound concentration. However, direct measurement of unbound concentrations is obstructive, and high individual variability of the unbound fraction of ceftriaxone was shown in children. We aim to evaluate and validate a method to predict unbound ceftriaxone concentrations in pediatric patients. Ninety-five pairs of concentrations (total and unbound) from 92 patients were measured by the bioanalysis method that we developed. The predictive performance of the three equations (empirical in vivo equation, disease-adapted equation, and multiple linear regression equation) was assessed by the mean absolute prediction error (MAPE), the mean prediction error (MPE), the proportions of the prediction error within ±30% (P 30) and ±50% (P 50), and linear regression of predicted versus actual unbound levels (R 2). The average total and unbound ceftriaxone concentrations were 126.18 ± 81.46 μg/ml and 18.82 ± 21.75 μg/ml, and the unbound fraction varied greatly from 4.75% to 39.97%. The MPE, MAPE, P 30, P 50, and R 2 of the empirical in vivo equation, disease equation, and multiple linear equation were 0.17 versus 0.00 versus 0.06, 0.24 versus 0.15 versus 0.27, 63.2% versus 89.5% versus 74.7%, 96.8% versus 97.9% versus 86.3%, and 0.8730 versus 0.9342 versus 0.9315, respectively. The disease-adapted equation showed the best predictive performance. We have developed and validated a bioanalysis method with one-step extraction pretreatment for the determination of total ceftriaxone concentrations, and a prediction equation of the unbound concentration is recommended. The proposed method can facilitate clinical practice and research on unbound ceftriaxone in children. (This study has been registered at ClinicalTrials.gov under identifier NCT03113344.).
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