Pediatric urolithiasis and antibiotic use: mechanisms and associated risks

Ruiz Ayón J.W.F.; Cornejo Chavez N.E. · Andes Pediatrica (2026) · DOI: 10.32641/andespediatr.v97i1.5787

Resumen

Pediatric urolithiasis is an increasingly common condition, with multiple factors involved in its etiology. Recently, a potential association has been suggested between the use of antibiotics, particularly cephalosporins, and kidney stone formation, mediated by alterations in the gut and urinary microbiota. Objective: To conduct a narrative review on the relationship between antibiotics and pediatric urolithiasis, identifying proposed mechanisms and associated clinical risks. Method: A narrative review of the literature was performed using PubMed, Scopus, and Google Scholar. Original studies published between 2004 and 2025 were selected, focusing on the pediatric population and addressing the link between antibiotic use and stone formation. Given the limited evidence available for certain antibiotic classes, relevant case reports were also included. Results: Potential mechanisms identified included intestinal and urinary dysbiosis, altered oxalate metabolism, changes in urinary pH, and urinary supersaturation. Most studies focused on ceftriaxone, limiting the generalizability of the findings. Conclusion: The use of antibiotics in children should be carefully evaluated, especially in those with predisposing factors for lithiasis. Further research is needed to better understand this relationship and develop effective preventive strategies.

Instituciones: Universidad Privada Antenor Orrego