Comparison of prevalence of hypercalciuria after intravenous injection of ceftriaxone versus ampicillin and cefotaxime in children with febrile infection

Abstract

Background and aim: Ceftriaxone is a third generation Cephalosporin and is often used to treat infections of the upper gastrointestinal tract and urinary tract infections. Due to some reported side effects of these drugs, such as urinary stone formation which may be related to hypercalciuria, this study aimed to determine the effect of ceftriaxone in the treatment of urinary tract infection with urinary stone formation. Methods: This cross-sectional study was carried out on 120 children from the age of 2 months to 14 years with febrile infections admitted to the Children's Hospital of Bandar Abbas in 2016. Patients were randomly allocated to two groups: The first group received a dose of ceftriaxone 100-50 mg/kg every 12 hours (depending on severity) and in the second group, ampicillin 50 mg/kg every 6 hours and cefotaxime 50 mg/kg every 8 hours were administered. For evaluation of hypercalciuria calcium to creatinine ratio (ca/cr) in random urine was used. Hypercalciuria was defined as Ca/Cr>0.6 in infants<1 years old and Ca/Cr>0.2 in infants>1 year old. Data was analyzed by IBM-SPSS version 21 through descriptive statistics, Chi-square, Fisher's exact test, independent samples t-test, and paired samples t-test. P-value less than 0.05 was considered significant. Results: A total of 120 children were enrolled in the study (78 in the ceftriaxone group vs. 42 in the ampicillin and ceftriaxone group). Both groups were similar in terms of age, gender, creatinine ratio and pre-treatment Ca/Cr ratio, but the difference between the groups was compared after treatment (0.339±0.204 in the ceftriaxone group and 0.236±0.159 in ampicillin and cefotaxime group) (p=0.005). The prevalence of hypercalciuria in the group receiving ceftriaxone, 15 (19.2%) and in the group receiving Ampicillin 2 (4.8%) (p<0.03). Conclusion: According to the information obtained from this study, we found out that ceftriaxone can increase the risk of hypercalciuria. Further studies with different populations could help to raise awareness of this issue.