Date of Award

Spring 2021

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Erin Wolf B.S.N., M.S., PA-C

Abstract

Introduction: Neonates and infants are at the highest risk for seizures in the first month of life. It is important to recognize and effectively treat seizures as permanent neurological damage can result. Phenobarbital is the first-line drug however it has deadly side effects. Levetiracetam has become an emerging antiepileptic drug of interest due to its favorable side effect profile and pharmacokinetics.

Methods: A literature search was performed in November of 2019 utilizing PubMed and ScienceDirect. A total of 11 articles were chosen based on the research question key terms, population, research design, and outcome. The literature was then analyzed, synthesized, and compared.

Results:A total of six articles were reviewed for comparison. Five of the articles directly compared levetiracetam to phenobarbital, while one used an additional drug. All five articles that provided statistical analyses concluded that seizures ceased with the use of levetiracetam. Additionally, only two children died in the levetiracetam group whereas multiple deaths occurred in the phenobarbital group.

Discussion: Studies were able to conclude statistical and clinical significance of levetiracetam over phenobarbital. Limitations were lack of blinding, small population size, lack of long term follow up, and the need for research directly comparing the drugs. The study design, sample size, age, dosing, outcome measurement, blinding, power, demographics, ability to stop seizures, and safety failure are all compared and the graphs can be found in the Appendix.

Conclusion: It can be concluded that levetiracetam is superior, more effective, and a safer choice compared to phenobarbital, confirmed by studies in multiple locations across the globe. The results of this research paper should be confirmed through large-scale clinical trials directly comparing the drugs. The evidence found is strong enough to encourage the use of levetiracetam over phenobarbital in clinical practice.

Comments

https://arcadia.zoom.us/rec/play/vQrhTl1meVn2tyTuJI_rtb2XhzJt047FqcwGg3-uleUcQ5hJRMJqCgUDZ-hxZSgoBQl3TQQuEzHfqw-w.URe1B8kh97Zjm4kn

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Efficacy and Safety of Levetiracetam Compared to Standard of Care Phenobarbital in Controlling Seizures in Pediatric Patients age 0-1-year-old

Introduction: Neonates and infants are at the highest risk for seizures in the first month of life. It is important to recognize and effectively treat seizures as permanent neurological damage can result. Phenobarbital is the first-line drug however it has deadly side effects. Levetiracetam has become an emerging antiepileptic drug of interest due to its favorable side effect profile and pharmacokinetics.

Methods: A literature search was performed in November of 2019 utilizing PubMed and ScienceDirect. A total of 11 articles were chosen based on the research question key terms, population, research design, and outcome. The literature was then analyzed, synthesized, and compared.

Results:A total of six articles were reviewed for comparison. Five of the articles directly compared levetiracetam to phenobarbital, while one used an additional drug. All five articles that provided statistical analyses concluded that seizures ceased with the use of levetiracetam. Additionally, only two children died in the levetiracetam group whereas multiple deaths occurred in the phenobarbital group.

Discussion: Studies were able to conclude statistical and clinical significance of levetiracetam over phenobarbital. Limitations were lack of blinding, small population size, lack of long term follow up, and the need for research directly comparing the drugs. The study design, sample size, age, dosing, outcome measurement, blinding, power, demographics, ability to stop seizures, and safety failure are all compared and the graphs can be found in the Appendix.

Conclusion: It can be concluded that levetiracetam is superior, more effective, and a safer choice compared to phenobarbital, confirmed by studies in multiple locations across the globe. The results of this research paper should be confirmed through large-scale clinical trials directly comparing the drugs. The evidence found is strong enough to encourage the use of levetiracetam over phenobarbital in clinical practice.