子どもの脳マラリアにおける発作頻度と死亡率に対するフェノバルビタルの効果:ランダム化され,制御された介入研究
J Crawley1, C Waruiru, S Mithwani
1Kenya Medical Research Institute/Wellcome Trust Centre for Geographic Medicine Research (Coast), Kilifi. jane.crawley@ndm.ox.ac.uk
Lancet (London, England)
|March 7, 2000
まとめ
フェノバルビタルは,子供の脳マラリアの発作を効果的に予防しますが,死亡率を大幅に増加させます. この高用量治療は,容認できない安全リスクがあるため推奨されません.
科学分野:
- 小児神経学について
- 感染症 感染症は感染症です.
- 臨床薬理学 臨床薬理学とは
背景:
- 発作は,小児における脳マラリアの共通で危険な合併症である.
- この合併症は,より高い死亡率と長期的な神経学的問題に関連しています.
研究 の 目的:
- 脳性マラリアの小児における発作の予防における肌内フェノバルビタルの有効性を評価する.
主な方法:
- 脳性マラリアの子どもを対象にランダム化制御試験が行われました.
- 参加者は,フェノバルビタル (20 mg/kg) の単一の筋内投与量またはプラセボを投与された.
- 発作頻度,死亡率,薬物耐性 (呼吸器のうつ,低血圧) を評価した.
主要な成果:
- フェノバルビタルは,プラセボと比較して発作の頻度を有意に減少させました (11%対27%).
- しかし,フェノバルビタル群では死亡率が2倍以上増加した (18%対8%).
- フェノバルビタルの使用で死亡率の増加が観察されましたが,特に複数のダイアゼパム投与量と併用された場合です.
結論:
- 20mg/kgのフェノバルビタルは,脳マラリアにおける発作予防に有効ですが,受け入れられない死亡リスクがあります.
- 安全性上の懸念のため,このフェノバルビタルの用量を使用することは推奨されません.
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