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Comparison between Phenobarbitone and Levetiracetam as the initial anticonvulsant in preterm neonatal seizures — a pilot randomized control trial in developing country setup
This study aimed to compare the efficacy and safety of intravenous Levetiracetam and Phenobarbitone in the treatment of seizures in preterm neonates. It was an open-labeled, parallel randomized controlled trial conducted in a tertiary Neonatal Intensive Care Unit, India. Total 48 preterm neonates (2...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9950002/ https://www.ncbi.nlm.nih.gov/pubmed/36823477 http://dx.doi.org/10.1007/s00431-023-04864-x |
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author | Gyandeep, Gummalla Behura, Sushree Smita Sahu, Sanjay Kumar Panda, Santosh Kumar |
author_facet | Gyandeep, Gummalla Behura, Sushree Smita Sahu, Sanjay Kumar Panda, Santosh Kumar |
author_sort | Gyandeep, Gummalla |
collection | PubMed |
description | This study aimed to compare the efficacy and safety of intravenous Levetiracetam and Phenobarbitone in the treatment of seizures in preterm neonates. It was an open-labeled, parallel randomized controlled trial conducted in a tertiary Neonatal Intensive Care Unit, India. Total 48 preterm neonates (28–36(+6) weeks) with clinical seizures were randomized to receive either Levetiracetam (LEV; 40 mg/kg, then 20 mg/kg) or Phenobarbitone (PB; 15 mg/kg, then 10 mg/kg) intravenously as first loading dose in ratio 1:1; second loading was given for persistent seizure. Efficacy was denoted by cessation of clinical seizures with first or second doses of the allotted antiepileptic, and remaining seizure-free for the next 24 h. The demographic characteristics of preterm neonates and seizure types were comparable between both groups. Clinical seizure was controlled in 19 (79%) neonates in LEV group and 17 (70%) neonates in PB group, RR 1.12 (95% CI: 0.80 to 1.55), p = 0.504. There was increased respiratory support in PB group 9 (38%) vs. 3 (13%) in LEV group, RR 3.0 (95% CI: 0.92 to 9.74), p = 0.06. Conclusion: Levetiracetam and Phenobarbitone were equally efficacious for clinical neonatal seizure control, but increased respiratory support was found with Phenobarbitone use. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00431-023-04864-x. |
format | Online Article Text |
id | pubmed-9950002 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-99500022023-02-24 Comparison between Phenobarbitone and Levetiracetam as the initial anticonvulsant in preterm neonatal seizures — a pilot randomized control trial in developing country setup Gyandeep, Gummalla Behura, Sushree Smita Sahu, Sanjay Kumar Panda, Santosh Kumar Eur J Pediatr Research This study aimed to compare the efficacy and safety of intravenous Levetiracetam and Phenobarbitone in the treatment of seizures in preterm neonates. It was an open-labeled, parallel randomized controlled trial conducted in a tertiary Neonatal Intensive Care Unit, India. Total 48 preterm neonates (28–36(+6) weeks) with clinical seizures were randomized to receive either Levetiracetam (LEV; 40 mg/kg, then 20 mg/kg) or Phenobarbitone (PB; 15 mg/kg, then 10 mg/kg) intravenously as first loading dose in ratio 1:1; second loading was given for persistent seizure. Efficacy was denoted by cessation of clinical seizures with first or second doses of the allotted antiepileptic, and remaining seizure-free for the next 24 h. The demographic characteristics of preterm neonates and seizure types were comparable between both groups. Clinical seizure was controlled in 19 (79%) neonates in LEV group and 17 (70%) neonates in PB group, RR 1.12 (95% CI: 0.80 to 1.55), p = 0.504. There was increased respiratory support in PB group 9 (38%) vs. 3 (13%) in LEV group, RR 3.0 (95% CI: 0.92 to 9.74), p = 0.06. Conclusion: Levetiracetam and Phenobarbitone were equally efficacious for clinical neonatal seizure control, but increased respiratory support was found with Phenobarbitone use. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00431-023-04864-x. Springer Berlin Heidelberg 2023-02-24 2023 /pmc/articles/PMC9950002/ /pubmed/36823477 http://dx.doi.org/10.1007/s00431-023-04864-x Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Research Gyandeep, Gummalla Behura, Sushree Smita Sahu, Sanjay Kumar Panda, Santosh Kumar Comparison between Phenobarbitone and Levetiracetam as the initial anticonvulsant in preterm neonatal seizures — a pilot randomized control trial in developing country setup |
title | Comparison between Phenobarbitone and Levetiracetam as the initial anticonvulsant in preterm neonatal seizures — a pilot randomized control trial in developing country setup |
title_full | Comparison between Phenobarbitone and Levetiracetam as the initial anticonvulsant in preterm neonatal seizures — a pilot randomized control trial in developing country setup |
title_fullStr | Comparison between Phenobarbitone and Levetiracetam as the initial anticonvulsant in preterm neonatal seizures — a pilot randomized control trial in developing country setup |
title_full_unstemmed | Comparison between Phenobarbitone and Levetiracetam as the initial anticonvulsant in preterm neonatal seizures — a pilot randomized control trial in developing country setup |
title_short | Comparison between Phenobarbitone and Levetiracetam as the initial anticonvulsant in preterm neonatal seizures — a pilot randomized control trial in developing country setup |
title_sort | comparison between phenobarbitone and levetiracetam as the initial anticonvulsant in preterm neonatal seizures — a pilot randomized control trial in developing country setup |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9950002/ https://www.ncbi.nlm.nih.gov/pubmed/36823477 http://dx.doi.org/10.1007/s00431-023-04864-x |
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