ro13-9904 and Ureteral-Calculi

To determine the safety of ceftriaxone in paediatric patients and systematically evaluate the categories and incidences of adverse drug reactions (ADRs) of ceftriaxone in paediatric patients.. We performed a systematic search in Medline, PubMed, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, International Pharmaceutical Abstracts and bibliographies of relevant articles up to December 2018 for all types of studies that assessed the safety of ceftriaxone in paediatric patients aged ≤18 years.. 112 studies met the inclusion criteria involving 5717 paediatric patients who received ceftriaxone and reported 1136 ADRs. The most frequent ADRs reported in prospective studies were gastrointestinal (GI) disorders (37.4 %, 292/780), followed by hepatobiliary disorders (24.6%, 192/780). Serious ADRs leading to withdrawal or discontinuation of ceftriaxone were reported in 86 paediatric patients. Immune haemolytic anaemia (34.9%, 30/86) and biliary pseudolithiasis (26.7%, 23/86) were the two major causes. Haemolytic anaemia following intravenous ceftriaxone led to death in 11 children whose primary disease was sickle cell disease. Almost all biliary pseudolithiasis are reversible. However, the incidence was high affecting one in five paediatric patients (20.7%).. GI ADRs are the most common toxicity of ceftriaxone in paediatric patients. Immune haemolytic anaemia and biliary pseudolithiasis are the most serious ADRs and the major reasons for discontinuation of ceftriaxone. Immune haemolytic anaemia is more likely in children with sickle cell disease and may cause death. Ceftriaxone should be used with caution in children with sickle cell disease.. CRD42017055428.

Topics: Anemia, Hemolytic; Anemia, Sickle Cell; Anti-Bacterial Agents; Ceftriaxone; Diarrhea; Digestive System Diseases; Exanthema; Humans; Nephrolithiasis; Pediatrics; Thrombocytosis; Ureteral Calculi; Urination Disorders

Topics: Anti-Bacterial Agents; Ceftriaxone; Child; Humans; Male; Ureteral Calculi

Noncontrast computed tomography (CT) has great advantage with higher sensitivity and more clear modalities in detecting urinary tract radiolucent calculi in patients with acute renal insufficiency (ARI) compared to other image diagnosis approaches. We report two cases (female, 28 years old; male, 39 years old) with persistent flank pain and acute anuria after the administration of ceftriaxone (4.0 g daily) for 2 days intravenously. No abnormality was found in the kidney-ureter- bladder (KUB) areas with plain abdomen X-rays. A diagnosis of bilateral hydronephrosis was made by ultrasound examination in both cases. Serum creatinine levels reached up to 257 and 810 μ mol/L (normal serum creatinine level is 40-130 μ mol/L), respectively. Vague density spots were noticed in the pelvis with noncontrast multidetector-row CT (MDCT) scanning. However, distinguishable clusters of high-density shadows were seen in pelvic areas with maximum intensity projections (MIP, CT values in 30-128 HU). Ceftriaxone crystal calculi were found on both sides of distal ureters under endoscopy. Renal function recovered in both patients after double-J ureteral stents were installed. Out results demonstrated that noncontrast MDCT scanning and MIP reconstruction as an effective diagnostic tool could provide clear images in detection of radiolucent calculi in urinary tract when conventional X-rays image are not suitable in the patients with obstructive anuria and ARI of unknown origin.

Topics: Acute Kidney Injury; Adult; Ceftriaxone; Creatinine; Female; Humans; Male; Radiographic Image Enhancement; Radiographic Image Interpretation, Computer-Assisted; Tomography, X-Ray Computed; Ultrasonography; Ureteral Calculi; Ureteral Obstruction

Endogenous endophthalmitis is a potentially blinding condition that occurs after the spread of organisms to the eye from a focus of infection elsewhere in the body. The holmium laser has gained increasing acceptance as being safe and effective for endoscopic lithotripsy. We report what we believe to be the first time endogenous endophthalmitis has been described as occurring after holmium laser lithotripsy, although it has been reported after extracorporeal shock wave lithotripsy. This 55-year-old woman developed infections in both eyes 2 to 3 weeks after the lithotripsy, with a good response to appropriate antibiotic treatment.

Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacteremia; Ceftazidime; Ceftriaxone; Cephalexin; Drug Therapy, Combination; Endophthalmitis; Female; Gentamicins; Holmium; Humans; Lithotripsy, Laser; Middle Aged; Pseudomonas Infections; Ureteral Calculi; Urinary Tract Infections; Vancomycin