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Fosphenytoin in infants of extremely low birth weight

R L Kriel1, R F Cifuentes

  • 1Department of Pediatrics, College of Pharmacy, University of Minnesota and Hennepin County Medical Center, Minneapolis, MN 55415, USA.

Pediatric Neurology
|April 13, 2001
PubMed

Insights

Fosphenytoin effectively converts to phenytoin in low-birth-weight newborns, aiding acute seizure management. While conversion was adequate, seizure control varied in these infants.

Area of Science:

  • Neonatal pharmacology
  • Neuroscience
  • Pediatric critical care

Background:

  • Fosphenytoin, a parenteral prodrug of phenytoin, offers advantages for acute seizure treatment with fewer cardiac and local adverse effects.
  • Limited data exists on fosphenytoin use and conversion in the neonatal population.
  • Concerns regarding the conversion of fosphenytoin to active phenytoin in newborns necessitate further investigation.

Observation:

  • Two low-birth-weight infants received fosphenytoin for seizure management.
  • Fosphenytoin conversion to phenytoin was monitored in these neonates.

Findings:

  • Fosphenytoin was adequately converted to phenytoin in both low-birth-weight infants.
  • Seizure control outcomes following fosphenytoin administration showed variability despite adequate conversion.

Implications:

  • Fosphenytoin appears to be a viable option for neonatal seizures, with effective prodrug conversion.
  • Further studies are needed to optimize fosphenytoin dosing for consistent seizure control in neonates.
  • This case series contributes to the limited experience with fosphenytoin in extremely low-birth-weight infants.

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