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Intramuscular marginally better than buccal midazolam for paediatric seizure

01 Aug 2020

Intramuscular midazolam appears to be better than buccal administrations for first-line treatment of paediatric seizures, a recent study has found.

Researchers enrolled 150 children with active seizures. Half of the participants received midazolam intramuscularly (mean age, 49±46 months), while the other half were given buccal midazolam (mean age, 45±37 months). The primary efficacy outcome was the proportion of patients with seizure cessation within 5 minutes of drug administration.

Thirty-two children saw cessation of seizure within 5 minutes of buccal midazolam administration, yielding a rate of 46 percent. In comparison 41 patients in the intramuscular arm achieved the efficacy endpoint, with a rate of 61 percent. The absolute difference was of borderline significance (15.5 percent; p=0.07).

Moreover, the average time from medication administration to seizure cessation was marginally shorter in the intramuscular midazolam group (15.9±28.7 vs 17.8±27.5 minutes; p=0.69). Cox regression analysis showed that the duration of seizures after intramuscular vs buccal midazolam was 13 percent shorter, though significance was not achieved (p=0.49).

In terms of safety, one patient in the intramuscular arm developed respiratory depression and hypotension within 3 minutes of medication administration. Patient recovered fully with intervention and within 15 minutes after drug administration. Such an event was not observed in the buccal midazolam group.

“We conclude that the efficacy and safety of intramuscular midazolam as first-line treatment for paediatric seizures compares favourably to buccal midazolam,” researchers said.

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Most Read Articles
2 days ago
Ivermectin confers benefits in the treatment of COVID-19, with a recent study showing that its use helps reduce the risk of death especially in patients with severe pulmonary involvement.
Yesterday
Mental health comorbidities are common among patients with type 2 diabetes mellitus and may lead to worse outcomes, a recent study has found.
Roshini Claire Anthony, 13 Nov 2020

Diabetes is a key risk factor for heart failure (HF), which is the leading cause of hospitalization in patients with or without diabetes. SGLT-2* inhibitors (SGLT-2is) have been shown to reduce the risk of hospitalization for HF (HHF) regardless of the presence or absence of diabetes.

Tristan Manalac, 5 days ago
The substitution of isoleucine to leucine at amino acid 97 (I97L) in the core region of the hepatitis B virus (HBV) seems to reduce its potency, decreasing the efficiency of both infection and the synthesis of the virus’ covalently closed circular (ccc) DNA, reports a new study presented at The Liver Meeting Digital Experience by the American Association for the Study of Liver Diseases (AASLD 2020).