A Comparative Study of Levetiracetam and Phenobarbital for Neonatal Seizures as a First Line Treatment
Objectives We aimed to evaluate the use of intravenous levetiracetam as the first-line treatment of neonatal seizures compared with phenobarbital. Methods The study was conducted on 104 neonates (0-28 days) with clinical seizures after inclusion criteria. They were assigned in equal ratio into 2 gro...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-12-01
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| Series: | Global Pediatric Health |
| Online Access: | https://doi.org/10.1177/2333794X221143572 |
| _version_ | 1811194625018298368 |
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| author | Nagwa Elsayed Akeel MD Hany Abdelaziz Suliman MD Ashraf Hamed Al-Shokary MD Asmaa Obada Ibrahim MD Naglaa M. Kamal MD Abobakr Abosree Abdelgalil MD Moustafa Kotb Elmala MD Hatem Hamed Elshorbagy MD Khaled Amin Nasef MD Ahmed Mahmoud Attia MD Mohamed Gamal El Din Fathallah MD |
| author_facet | Nagwa Elsayed Akeel MD Hany Abdelaziz Suliman MD Ashraf Hamed Al-Shokary MD Asmaa Obada Ibrahim MD Naglaa M. Kamal MD Abobakr Abosree Abdelgalil MD Moustafa Kotb Elmala MD Hatem Hamed Elshorbagy MD Khaled Amin Nasef MD Ahmed Mahmoud Attia MD Mohamed Gamal El Din Fathallah MD |
| author_sort | Nagwa Elsayed Akeel MD |
| collection | DOAJ |
| description | Objectives We aimed to evaluate the use of intravenous levetiracetam as the first-line treatment of neonatal seizures compared with phenobarbital. Methods The study was conducted on 104 neonates (0-28 days) with clinical seizures after inclusion criteria. They were assigned in equal ratio into 2 groups; 1 included neonates who received phenobarbitone, and the other included neonates who received levetiracetam. Neonates were loaded with 20 mg/kg of intravenous drug-A (phenobarbitone) or drug-B (levetiracetam). In persistent seizures, a second loading dose of the same drug was given. Crossover to other drugs occurred if seizures persisted after the second dose of the same drug. The proportion of neonates who achieved cessation of seizures following the first or second loading dose of either drug-A or drug-B (PB or LEV) was the main outcome measure provided that they remained free of seizure for the following 24 hours. Results After 1 or 2 doses of Levetiracatam or Phenobarbitone, clinical seizures stopped (and remained seizure-free for 24 hours) in 41 (78.84%) and 34 (65.38%) patients, respectively ( P = .01). Neonates in the LEV group showed better seizure control than neonates in the PB group (RR = 0.57; 95% CI (0.17, 0.80). We did not report any adverse drug reactions in the LEV group. However, 12 (23.07%) neonates developed adverse drug reactions in the PB Group. Conclusion Levetiracetam is considered an effective and safe drug as a first-line AED in neonatal seizures. |
| first_indexed | 2024-04-12T00:29:51Z |
| format | Article |
| id | doaj.art-5708e57ccc5342f7ba457a9f134a2f25 |
| institution | Directory Open Access Journal |
| issn | 2333-794X |
| language | English |
| last_indexed | 2024-04-12T00:29:51Z |
| publishDate | 2022-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Global Pediatric Health |
| spelling | doaj.art-5708e57ccc5342f7ba457a9f134a2f252022-12-22T03:55:22ZengSAGE PublishingGlobal Pediatric Health2333-794X2022-12-01910.1177/2333794X221143572A Comparative Study of Levetiracetam and Phenobarbital for Neonatal Seizures as a First Line TreatmentNagwa Elsayed Akeel MD0Hany Abdelaziz Suliman MD1Ashraf Hamed Al-Shokary MD2Asmaa Obada Ibrahim MD3Naglaa M. Kamal MD4Abobakr Abosree Abdelgalil MD5Moustafa Kotb Elmala MD6Hatem Hamed Elshorbagy MD7Khaled Amin Nasef MD8Ahmed Mahmoud Attia MD9Mohamed Gamal El Din Fathallah MD10Pediatric department, Benha University, Benha, EgyptPediatric department, Benha University, Benha, EgyptPediatric department, Benha University, Benha, EgyptPediatric department, Ain Shams University, Cairo, EgyptPediatric department, Cairo University, Cairo, EgyptPediatric department, Cairo University, Cairo, EgyptPediatric department, Nizwa Hospital, Nizwa, Sultanate of OmanProfessor of Pediatrics and Pediatric Neurology, Faculty of medicine, Menoufia University, Shebeen Elkom, EgyptPediatric department, Cairo University, Cairo, EgyptPediatric department, Qualiob General Hospital, Qaliob, EgyptPediatric department, Cairo University, Cairo, EgyptObjectives We aimed to evaluate the use of intravenous levetiracetam as the first-line treatment of neonatal seizures compared with phenobarbital. Methods The study was conducted on 104 neonates (0-28 days) with clinical seizures after inclusion criteria. They were assigned in equal ratio into 2 groups; 1 included neonates who received phenobarbitone, and the other included neonates who received levetiracetam. Neonates were loaded with 20 mg/kg of intravenous drug-A (phenobarbitone) or drug-B (levetiracetam). In persistent seizures, a second loading dose of the same drug was given. Crossover to other drugs occurred if seizures persisted after the second dose of the same drug. The proportion of neonates who achieved cessation of seizures following the first or second loading dose of either drug-A or drug-B (PB or LEV) was the main outcome measure provided that they remained free of seizure for the following 24 hours. Results After 1 or 2 doses of Levetiracatam or Phenobarbitone, clinical seizures stopped (and remained seizure-free for 24 hours) in 41 (78.84%) and 34 (65.38%) patients, respectively ( P = .01). Neonates in the LEV group showed better seizure control than neonates in the PB group (RR = 0.57; 95% CI (0.17, 0.80). We did not report any adverse drug reactions in the LEV group. However, 12 (23.07%) neonates developed adverse drug reactions in the PB Group. Conclusion Levetiracetam is considered an effective and safe drug as a first-line AED in neonatal seizures.https://doi.org/10.1177/2333794X221143572 |
| spellingShingle | Nagwa Elsayed Akeel MD Hany Abdelaziz Suliman MD Ashraf Hamed Al-Shokary MD Asmaa Obada Ibrahim MD Naglaa M. Kamal MD Abobakr Abosree Abdelgalil MD Moustafa Kotb Elmala MD Hatem Hamed Elshorbagy MD Khaled Amin Nasef MD Ahmed Mahmoud Attia MD Mohamed Gamal El Din Fathallah MD A Comparative Study of Levetiracetam and Phenobarbital for Neonatal Seizures as a First Line Treatment Global Pediatric Health |
| title | A Comparative Study of Levetiracetam and Phenobarbital for Neonatal Seizures as a First Line Treatment |
| title_full | A Comparative Study of Levetiracetam and Phenobarbital for Neonatal Seizures as a First Line Treatment |
| title_fullStr | A Comparative Study of Levetiracetam and Phenobarbital for Neonatal Seizures as a First Line Treatment |
| title_full_unstemmed | A Comparative Study of Levetiracetam and Phenobarbital for Neonatal Seizures as a First Line Treatment |
| title_short | A Comparative Study of Levetiracetam and Phenobarbital for Neonatal Seizures as a First Line Treatment |
| title_sort | comparative study of levetiracetam and phenobarbital for neonatal seizures as a first line treatment |
| url | https://doi.org/10.1177/2333794X221143572 |
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