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Ceftriaxone Induced Nephrolithiasis in Pediatrics

  • Pham, Alex Kiet (Pacific University: Master of Science in Physician Assistant Studies)
  • Robinson, Jesse (Pacific University: Master of Science in Physician Assistant Studies)


Background: Ceftriaxone is an antibiotic commonly used for a variety of different conditions including pelvic inflammatory disease, urinary tract infections, respiratory infections, and meningitis. Kidney stones or nephrolithiasis are a contributing factor to patient progression to renal disease. Ceftriaxone has been associated with the formation of kidney stones via precipitation with calcium in the body.

Methods: An exhaustive search of available medical literature using MEDLINE-PubMed, Web of Science, and CINAHL was conducted. The following search terms were used: nephrolithiasis, kidney stones, ceftriaxone, children, pediatric, teen, adolescent, youth. Included were articles concerned with nephrolithiasis formation in pediatric patients after receiving short course, high dose ceftriaxone. Other inclusion criteria required human studies, published in English language, and no renal disease. Risk of bias for each study was evaluated using JAMAevidence critical appraisal worksheets.

Results: The initial search yielded 34 articles from PubMed, 42 articles from Web of Science, and 3 articles from CINAHL for review. After eliminating duplicates and screening for studies that matched the inclusion and exclusion criteria, there were a total of 4 articles. Of these articles, 3 of them were quasi-experimental prospective studies that observed the outcome of new onset nephrolithiasis after treatment with ceftriaxone in pediatric patients.

Conclusion: Appraisal of the literature available showed a higher incidence of nephrolithiasis in pediatric patients after they were treated with a short course of high dose ceftriaxone. However, the severity of the nephrolithiasis was low and the complications from such were negligible. All accounts of nephrolithiasis in these patients were asymptomatic and most self resolved within 4 weeks. There were exceptions with cases that had kidney stones remaining up to 7 and 9 months. These findings were in patients who had no previous or underlying renal complications and normal metabolic function. Keywords: Nephrolithiasis, ceftriaxone, pediatrics, children


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