Urolithiasis – a potential complication of ceftriaxone therapy

A cohort of 238 children diagnosed with cystopyelonephritis were retrospectively analyzed in 2011 to assess the possible ceftriaxone risk of urinary stone formation. All children were treated with ceftriaxone in a standard dosage of 60 mg/kg/day for 10 days. Urinary tract imaging revealed anomalies in 73, vesicoureteral refl ux in 66 and hydronephrosis in 7 children. No ceftriaxone stone formation and no sign of abdominal colic or macro/microhematuria was found during one-month monitoring. Ceftriaxone administration is quite safe in the usual dosage of 60 mg/kg/24 h for 10 days. Caution is only warranted in children requiring higher dosage of ≥100 mg/kg/24 h and prolonged administration. In such cases, we recommend ultrasound of urinary tract and gallbladder screening for hypercalciuria and alkalization of urine.

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