Drug, Healthcare and Patient Safety (Dec 2018)
Ceftriaxone-associated nephrolithiasis and gallstone in adults
Abstract
Ghodsiyeh Azarkar,1 Motahare Mahi Birjand,2 Alireza Ehsanbakhsh,3 Bita Bijari,1 Mohammad Reza Abedini,4 Masood Ziaee1 1Infectious Disease Research Center, Birjand University of Medical Sciences, Birjand, Iran; 2Student Research Committee, Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran; 3Department of Radiology, Valiasr Hospital, Birjand University of Medical Sciences, Birjand, Iran; 4Cellular and Molecular Research Center, Department of Pharmacology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran Background: Ceftriaxone (CTX) is widely used for the treatment of bacterial infections; however, side effects such as gallstone and nephrolithiasis have been reported in children. There is limited information about urinary tract calculi as CTX side effects in adults. Therefore, the present study was aimed to evaluate the incidence of gallstone and nephrolithiasis following CTX administration.Methods: The present study was conducted in the Vali-e-Asr Hospital. Eighty-four patients with various infectious diseases with different daily treatment (mean ± SD: 4.19±2.54) were included in this study, consisting of 49 females and 35 males. The mean of total doses used in patients was 10.2143 (SD: 5.8585). To detect possible gallstone, gallbladder sludge, and urolithiasis, patients were evaluated by serial ultrasound before and after CTX treatment. Patients with renal and hepatobiliary dysfunction were excluded from the study and did not receive any nephrotoxic drugs during this study. Demographic parameters including age, sex, body mass index, dosage of CTX, as well as the duration of treatment and hospitalization were determined. Statistical significances were determined using Fisher’s exact test and independent t-test.Results: Results from our study showed that the incidence of gallstone and nephrolithiasis were 8.8% and 1.5% following CTX administration, respectively. Surprisingly, we found a significant correlation in terms of age between patients with and without gallstone (P=0.03).Conclusion: Our findings suggest that the patients’ age might play a role in the development of such a complication. This indicates the need for a close monitoring of CTX-treated patients to assess the possible formation of gallstone and nephrolithiasis. Keywords: ceftriaxone, gallstones, nephrolithiasis, sonography
