{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:05:15Z","timestamp":1790229915199,"version":"4.1.0"},"reference-count":113,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.guidetopharmacology.org\/GRAC\/LigandDisplayForward?ligandId=5326\">Ceftriaxone<\/jats:ext-link>\n                    can cause acute haemolysis. Its clinical presentation, risk factors, and outcomes remain incompletely characterized. We conducted a systematic review of published cases with patient\u2010level data, following international guidelines and with registration in PROSPERO (CRD420261338709). Reports were identified through three bibliographic databases. Only cases meeting a predefined reporting completeness threshold were included. Clinical features, laboratory findings, management strategies, and outcomes were analysed, with prespecified comparisons between paediatric and adult patients. Eighty\u2010nine reports describing 101 patients were included: 57% were aged \u226418\u2009years and 53% were male. Acute kidney injury and disseminated intravascular coagulation were reported in 23% and 13% of patients, respectively. Overall mortality was 24%. Mortality was not associated with sex, age group, preexisting haematological conditions, or acute kidney injury, but was significantly higher among patients with disseminated intravascular coagulation. Mortality declined markedly from 80% among cases reported between 1991 and 2000 to 18% among those reported thereafter. A direct antiglobulin test was performed in 89% of cases and was positive in 93%. Among characterized positive tests, complement deposition was present in 90%, either alone (53%) or combined with immunoglobulin G (37%). Management primarily consisted of ceftriaxone discontinuation. Red blood cell transfusions were administered in 67% of cases, corticosteroids in 45%, and polyclonal immunoglobulins in 16%. Ceftriaxone\u2010associated haemolytic anaemia is generally associated with a positive direct antiglobulin test and carries a substantial risk of rapid fatal deterioration. Given its abrupt presentation, a high index of suspicion, early recognition, and prompt discontinuation of ceftriaxone are critical.\n                  <\/jats:p>","DOI":"10.1002\/bcp.70818","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:51:56Z","timestamp":1790229116000},"source":"Crossref","is-referenced-by-count":0,"title":["Ceftriaxone\u2010associated immune haemolytic anaemia: A patient\u2010level systematic review"],"prefix":"10.1002","author":[{"given":"Sonja","family":"Miotti","sequence":"first","affiliation":[{"name":"Family medicine, Faculty of Biomedical Sciences Universit\u00e0 della Svizzera Italiana  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giada","family":"Wyttenbach","sequence":"additional","affiliation":[{"name":"Family medicine, Faculty of Biomedical Sciences Universit\u00e0 della Svizzera Italiana  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario G.","family":"Bianchetti","sequence":"additional","affiliation":[{"name":"Family medicine, Faculty of Biomedical Sciences Universit\u00e0 della Svizzera Italiana  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Lavagno","sequence":"additional","affiliation":[{"name":"Paediatric Emergency Department University Children's Hospital Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Camozzi","sequence":"additional","affiliation":[{"name":"Department of Anesthesia H\u00f4pital du Valais  Sion Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregorio P.","family":"Milani","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende \u2013 Paediatric Unit Annunziata Hospital  Cosenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Gualtieri","sequence":"additional","affiliation":[{"name":"Division of Paediatrics, Department of Women\u2010Mother\u2010Child Lausanne University Hospital and University of Lausanne  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiano A. 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