Ceftriaxone-induced cholelithiasis in pediatrics: pooled frequency, symptoms, and associated factors — systematic review and meta-analysis
Bibliographic record
Abstract
Ceftriaxone is commonly used in pediatric infections, but its association with cholelithiasis poses potential health concerns. To determine the pooled frequency of ceftriaxone-induced cholelithiasis in pediatric patients and identify factors commonly associated with its occurrence. Web of Science, PubMed, Google Scholar, and Scopus were systematically searched until March 2024.Studies reporting ceftriaxone-induced cholelithiasis in pediatric patients (0-18 years) were included. Randomized controlled trials (RCTs) and prospective and retrospective cohort studies published in English were eligible. PRISMA guidelines were followed. The Newcastle‒Ottawa Scale and CASP tools were used to assess risk of bias. A random-effects meta-analysis estimated the pooled frequency. Sensitivity analysis was conducted to explore heterogeneity. The primary outcome was the pooled frequency of ceftriaxone-induced cholelithiasis. Secondary outcomes included identification of factors commonly associated with its occurrence and their impact on symptom burden. Eleven studies (1 RCT, 10 cohort studies) met the inclusion criteria. The pooled frequency of cholelithiasis was 15% (95% CI: 9-23%), with significant heterogeneity (I² = 81.76%). Commonly associated factors included high ceftriaxone doses (> 2 g/day), prolonged use (> 5 days), short bolus injections, and dehydration. Most cases resolved upon discontinuation, but symptomatic patients experienced nausea, vomiting, and abdominal pain. Ceftriaxone-induced cholelithiasis is relatively common in pediatric patients, particularly those with associated risk factors. Clinicians should monitor for biliary complications and consider alternative treatments when feasible. PROSPERO REGISTRATION: CRD42024503807.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.037 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.023 | 0.054 |
| Bibliometrics | 0.010 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".