Seftriakson Tedavisine Bağlı Safra Taşı ve Safra Çamuru

Abstract

Seftriakson, enfeksiyon tedavisinde sık kullanılan üçüncü kuşak sefalosporindir. Safra kesesinde geçici taş ya da çamur oluşumu psödolitiyazis olarak adlandırılır. Seftriaksona bağlı psödolitiyazis olgularının çoğunun bulgu vermemesi nedeniyle seftriakson tedavisi alan hastalarda psödolitiyazis sıklığını ve seyrini belirlemek amacıyla bir pilot çalışma yaptık. Bakteriyel menenjit ve pnömoni nedeniyle hastaneye yatırılan ve 100 mg/kg/gün dozunda seftriakson tedavisi alan 13 hasta çalışmaya alındı. Tedavi öncesi ve tedavinin onuncu günü ultrasonografik inceleme yapıldı. Safra çamuru veya taş saptanan hastalarda tedavi kesildikten sonra bir hafta aralarla ultrasonografik inceleme tekrarlandı. Başlangıçta ultrasonografik inceleme bulguları normaldi. Tedavinin 10. gününde dört hastada (%31) psödolitiyazis saptandı. Olguların üçünde safra taşı, birinde safra çamuru ile birlikte taş görüntülendi. Bu olguların hiçbirinde bulgu olmamasına rağmen seftriakson tedavisi kesildi. Yapılan ultrasonografik izlemde tedavi kesildikten 22-45 gün sonra psödolitiyazisin kaybolduğu görüldü. Sonuç olarak seftriakson verilen hastalarda psödolitiyazis beklenen bir komplikas-yondur ve tedavi kesildikten sonra kendiliğinden düzelmektedir. Gallbladder Stone or Sludge Related to Ceftriaxone Treatment Ceftriaxone is a widely used third generation cephalosporin. Transient gallbladder stone or sludge formation called pseudolithiasis. We planned a pilot study, to evaluate the incidence of gallbladder pseudolithiasis in children treated with ceftriaxone as most of the ceftriaxone induced pseudolithiasis cases are asymptomatic. In this study 13 children treated with ceftriaxone (100 mg/kg/day) for pneumonia and meningitis were examined. Each study patient had ultrasound examinations of gallbladder at the beginning and tenth day of the ceftriaxone treatment. If any abnormality was detected, scanning was repeated weekly after the end of the ceftriaxone treatment. All of the initial ultrasonographic examinations were normal. Pseudolithiasis was detected in four (%31) of the patients at the tenth day of ceftriaxone the rapy, 3 had gallstones and 1 had gallstone together with sludge. Although all patients were asymptomatic, ceftriaxone treatment was discontinued. Pseudolithiasis completely resolved in 22-45 days after the end of the treatment. As a result pseudolithiasis is an expected complication of ceftriaxone treatment, it resolves spontaneously after the treatment.

Keywords

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References

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