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Theophylline or caffeine: which is best for apnea of prematurity?
1Women and Infants' Hospital, 101 Dudley Street, Providence, RI 02905-2401, USA. jmbagannon@aol.com
Insights
Apnea of prematurity is common in premature infants. Caffeine citrate is recommended over theophylline due to its dosing, predictable levels, faster action, and fewer side effects.
Area of Science:
- Neonatal Medicine
- Pharmacology
Background:
- Apnea of prematurity affects infants under 30 weeks gestation.
- Methylxanthines like theophylline and caffeine are standard treatments.
Purpose of the Study:
- To compare the efficacy and safety of caffeine citrate versus theophylline for apnea of prematurity.
- To establish the preferred methylxanthine for treating premature infants.
Main Methods:
- Comparative analysis of theophylline and caffeine citrate in treating apnea of prematurity.
- Evaluation of drug efficacy, dosing, plasma concentration, onset of action, and side effect profiles.
Main Results:
- Both theophylline and caffeine citrate are equally effective in preventing apnea.
- Caffeine citrate offers advantages including once-daily dosing, predictable plasma concentrations, and fewer side effects compared to theophylline.
Conclusions:
- Caffeine citrate is the preferred initial pharmacologic treatment for apnea of prematurity.
- The advantages of caffeine citrate make it a superior choice for managing this condition in premature infants.
Abstract:
Apnea of prematurity is a common problem of the premature infant under 30 weeks gestation. Theophylline and caffeine, two methylxanthines, are widely used to treat this condition. The drugs are equally effective in preventing apnea in the premature infant. Caffeine citrate has many advantages over theophylline, however, including once-a-day dosing, more predictable plasma concentrations, earlier onset of action, and minimal side effects. Caffeine is therefore the initial drug of choice for apnea of prematurity.