Jornal de doenças infecciosas e terapia

Abstrato

Ceftriaxone-Associated Cholelithiasis in Adult Patients with Bacterial Meningitis

Hideto Nakajima, Shin Ota, Takahiko Hirose, Takafumi Hosokawa, Shimon Ishida and Fumiharu Kimura

Ceftriaxone is known to induce gallstones and intrabiliary debris as the adverse effects. Ceftriaxone-related cholelithiasis occurs mainly in children treated with a high dosage of ceftriaxone for severe infections and has been rarely reported in adults. Here we report two cases of bacterial meningitis, with cholelithiasis complication developed during ceftriaxone treatment. A 65 year old man and a 66 year old man were treated with long-term (3 weeks) administration of high-dose ceftriaxone (4 g/day) for bacterial meningitis. Both patients had renal dysfunction, which may have affected gallstone formation. In one patient, gallstones spontaneously disappeared after discontinuing ceftriaxone treatment. However, the other patient needed the drainage by endoscopic retrograde cholangiopancreatography. These events are associated with elevated doses of ceftriaxone and require particular attention in the elderly and patients with renal dysfunction.