Acute cholecystitis and pancreatitis in a patient with biliary sludge associated with the use of ceftriaxone: a rare but potentially severe complication
Famularo, G.; Polchi, S.; De Simone, C.
Annali Italiani di Medicina Interna Organo Ufficiale Della Societa Italiana di Medicina Interna 14(3): 202-204
1999
ISSN/ISBN: 0393-9340 PMID: 10566187 Document Number: 6104
Ceftriaxone may precipitate in the bile leading to the formation of biliary sludge. Biliary complications, even serious ones, have rarely been described in patients treated with this antibiotic. A 71-year-old woman presented to the emergency room with biliary sludge complicated by acute cholecystitis and pancreatitis after 10 days of treatment with ceftriaxone (2 g, 40 mg/kg per day). There had been no evidence of sludge or gallstones on a transabdominal ultrasonography performed 6 months earlier. The patient underwent open cholecystectomy and recovered fully. Ceftriaxone should be kept in mind as a potential cause of biliary sludge. In most cases, resolution of sludge occurs after interruption of ceftriaxone. Young subjects, patients receiving a prolonged course and a daily dose > or = 40 mg/kg, and subjects with impaired gallbladder emptying have a greater risk of ceftriaxone-associated sludge. Cholecystectomy is the definitive therapy for severe complications.
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