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Survey About Second-Line Agents for Pediatric Convulsive Status Epilepticus
Marguerite Tyson1, Rebecca Trenear2, Sophie Skellett3
1From the Paediatric Intensive Care Unit, Great Ormond Street Hospital.
Pediatric Emergency Care
|May 5, 2022
Summary
Pediatric clinicians prefer levetiracetam over phenytoin as a second-line treatment for convulsive status epilepticus (CSE). Current guidelines should be updated to include levetiracetam for improved treatment flexibility.
Area of Science:
- Pediatric Neurology
- Emergency Medicine
- Clinical Pharmacology
Background:
- Convulsive status epilepticus (CSE) is a common pediatric neurological emergency with significant morbidity.
- Current UK guidelines recommend phenytoin as the second-line treatment for CSE.
- Recent trials show levetiracetam is noninferior to phenytoin for CSE.
Purpose of the Study:
- To assess UK and Ireland clinicians' current and preferred second-line agents for pediatric CSE.
- To evaluate the impact of recent evidence on clinical practice regarding CSE management.
Main Methods:
- An online survey was distributed to clinicians in 67 emergency departments and 29 pediatric intensive care units.
- The survey targeted healthcare professionals treating pediatric CSE in the UK and Ireland.
- Data collection focused on current practices and preferences for second-line CSE agents.
Main Results:
- Most clinicians currently use phenytoin as per existing guidelines.
- Clinicians expressed a desire for greater flexibility in selecting second-line agents.
- Levetiracetam emerged as the preferred alternative to phenytoin among surveyed clinicians.
Conclusions:
- Levetiracetam should be considered a preferred second-line agent for pediatric CSE.
- UK clinical guidelines (NICE) should be updated to include levetiracetam alongside phenytoin.
- Updated guidelines will enhance treatment options and flexibility for pediatric CSE management.
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