{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T01:56:20Z","timestamp":1780624580400,"version":"3.54.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the efficacy and safety of levetiracetam (LEV) in comparison to phenytoin (PHT) as second line antiseizure medication (ASM) for Pediatric convulsive status epilepticus (SE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data source<\/jats:title>\n                    <jats:p>PubMed, Embase, Google scholar\/Google, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study selection<\/jats:title>\n                    <jats:p>Randomized controlled trials (RCTs) assessing LEV and PHT as second line agent for convulsive SE in children &amp;lt;18\u2009years published between 1 January 2000 and 30 November 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction<\/jats:title>\n                    <jats:p>The data were pooled regarding the proportion of children achieving seizure cessation within 5\u201360\u2009min of completion of study drug infusion (primary outcome); and seizure cessation within 5\u2009min, time to achieve seizure cessation, seizure recurrence between 1 to 24\u2009h, intubation and cardiovascular instability (secondary outcomes). Data were analyzed using RevMan version 5.4 and quality analysis was done using Cochrane risk-of-bias tool. The study protocol was registered with PROSPERO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data synthesis<\/jats:title>\n                    <jats:p>Twelve RCTs with 2293 children were included. Seizure cessation within 5\u201360\u2009min was similar with both the drugs [82% in LEV vs. 77.5% in PHT, risk ratio (RR) = 1.04, 95% confidence interval (95% CI) 0.97\u20131.11, p\u2009=\u20090.30]. Seizure recurrences within 1\u201324\u2009h was higher with PHT in comparison to LEV (16.6% vs. 9.7%, RR\u2009=\u20090.63, 95% CI 0.44\u20130.90, p\u2009=\u20090.01). Higher proportion of children in PHT group required intubation and mechanical ventilation (21.4% vs. 14.2%, RR\u2009=\u20090.54, 95% CI 0.30\u20130.98, p\u2009=\u20090.04). Seizure cessation within 5\u2009min, time to achieve seizure cessation, and cardiovascular instability were similar with both the drugs. Three RCTs were at low risk of bias and nine were at high risk of bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The efficacy of LEV is similar to PHT as second line ASM for Pediatric convulsive SE. Seizure recurrences between 1 to24\u2009h and requirement of intubation and mechanical ventilation were significantly higher with PHT in comparison to LEV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/tropej\/fmab014","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T15:25:26Z","timestamp":1614093926000},"source":"Crossref","is-referenced-by-count":9,"title":["Efficacy and Safety of Levetiracetam vs. Phenytoin as Second Line Antiseizure Medication for Pediatric Convulsive Status Epilepticus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.1093","volume":"67","author":[{"given":"Suresh Kumar","family":"Angurana","sequence":"first","affiliation":[{"name":"Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renu","family":"Suthar","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,6,5]]},"reference":[{"key":"2021070811475301300_fmab014-B1","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1111\/epi.13121","article-title":"A definition and classification of status epilepticus\u2014report of the ILAE task force on classification of status epilepticus","volume":"56","author":"Trinka","year":"2015","journal-title":"Epilepsia"},{"key":"2021070811475301300_fmab014-B2","doi-asserted-by":"crossref","first-page":"48","DOI":"10.5698\/1535-7597-16.1.48","article-title":"Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the guideline committee of the American epilepsy society","volume":"16","author":"Glauser","year":"2016","journal-title":"Epilepsy Curr"},{"key":"2021070811475301300_fmab014-B3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.seizure.2018.08.021","article-title":"The burden of pediatric status epilepticus: epidemiology, morbidity, mortality, and costs","volume":"68","author":"Gurcharran","year":"2019","journal-title":"Seizure"},{"key":"2021070811475301300_fmab014-B4","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1111\/j.1528-1167.2009.02323.x","article-title":"Refractory status epilepticus: a prospective observational study","volume":"51","author":"Novy","year":"2010","journal-title":"Epilepsia"},{"key":"2021070811475301300_fmab014-B5","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/S0140-6736(06)69043-0","article-title":"Incidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study","volume":"368","author":"Chin","year":"2006","journal-title":"Lancet"},{"key":"2021070811475301300_fmab014-B6","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s13312-020-1753-6","article-title":"Clinical profile and short-term outcome of pediatric status epilepticus at a tertiary-care center in northern India","volume":"57","author":"Chetan","year":"2020","journal-title":"Indian Pediatr"},{"key":"2021070811475301300_fmab014-B7","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1002\/ana.10286","article-title":"Status epilepticus in a population-based cohort with childhood-onset epilepsy in Finland","volume":"52","author":"Sillanpaa","year":"2002","journal-title":"Ann Neurol"},{"key":"2021070811475301300_fmab014-B8","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.seizure.2019.09.005","article-title":"Status Epilepticus in Pediatric patients Severity Score (STEPSS): a clinical score to predict the outcome of status epilepticus in children\u2014a prospective cohort study","volume":"71","author":"Sidharth Sharma","year":"2019","journal-title":"Seizure"},{"key":"2021070811475301300_fmab014-B9","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1111\/epi.13653","article-title":"Time to electroencephalography is independently associated with outcome in critically ill neonates and children","volume":"58","author":"Sanchez Fernandez","year":"2017","journal-title":"Epilepsia"},{"key":"2021070811475301300_fmab014-B10","doi-asserted-by":"crossref","first-page":"2819","DOI":"10.1093\/brain\/awr239","article-title":"Death within 8 years after childhood convulsive status epilepticus: a population-based study","volume":"134","author":"Pujar","year":"2011","journal-title":"Brain"},{"key":"2021070811475301300_fmab014-B11","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1007\/s13312-014-0543-4","article-title":"Consensus guidelines on management of childhood convulsive status epilepticus","volume":"51","author":"Mishra","year":"2014","journal-title":"Indian Pediatr"},{"key":"2021070811475301300_fmab014-B12","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1007\/s12098-011-0604-9","article-title":"Management of acute seizure and status epilepticus in pediatric emergency","volume":"79","author":"Sasidaran","year":"2012","journal-title":"Indian J Pediatr"},{"key":"2021070811475301300_fmab014-B13","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.seizure.2018.01.025","article-title":"Consensus research priorities for paediatric status epilepticus: a Delphi study of health consumers, researchers and clinicians","volume":"56","author":"Furyk","year":"2018","journal-title":"Seizure"},{"key":"2021070811475301300_fmab014-B14","doi-asserted-by":"crossref","first-page":"33","DOI":"10.2165\/00003088-200342010-00002","article-title":"Fosphenytoin: clinical pharmacokinetics and comparative advantages in the acute treatment of seizures","volume":"42","author":"Fischer","year":"2003","journal-title":"Clin Pharmacokinet"},{"key":"2021070811475301300_fmab014-B15","doi-asserted-by":"crossref","first-page":"107289","DOI":"10.1016\/j.yebeh.2020.107289","article-title":"Efficacy and safety profile of intravenous levetiracetam versus phenytoin in convulsive status epilepticus and acute repetitive seizures in children","volume":"111","author":"Besli","year":"2020","journal-title":"Epilepsy Behav"},{"key":"2021070811475301300_fmab014-B16","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1177\/0883073816641187","article-title":"A comparison of intravenous levetiracetam and valproate for the treatment of refractory status epilepticus in children","volume":"31","author":"\u0130\u015fg\u00fcder","year":"2016","journal-title":"J Child Neurol"},{"key":"2021070811475301300_fmab014-B17","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.seizure.2015.07.004","article-title":"The adverse event profile of levetiracetam: a meta-analysis on children and adults","volume":"31","author":"Verrotti","year":"2015","journal-title":"Seizure"},{"key":"2021070811475301300_fmab014-B18","doi-asserted-by":"crossref","first-page":"107286","DOI":"10.1016\/j.yebeh.2020.107286","article-title":"Levetiracetam vs. phenytoin as 2nd-line treatment for status epilepticus: a systematic review and meta-analysis","volume":"111","author":"DeMott","year":"2020","journal-title":"Epilepsy Behav"},{"key":"2021070811475301300_fmab014-B19","article-title":"Efficacy, safety, and economics of intravenous levetiracetam for status epilepticus: a systematic review and meta-analysis","author":"Yi","journal-title":"Front Pharmacol"},{"key":"2021070811475301300_fmab014-B20","doi-asserted-by":"crossref","first-page":"106466","DOI":"10.1016\/j.yebeh.2019.106466","article-title":"Intravenous antiepileptic drugs in adults with benzodiazepine-resistant convulsive status epilepticus: a systematic review and network meta-analysis","volume":"101","author":"Brigo","year":"2019","journal-title":"Epilepsy Behav"},{"key":"2021070811475301300_fmab014-B21","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.seizure.2013.12.007","article-title":"The relative effectiveness of five antiepileptic drugs in treatment of benzodiazepine-resistant convulsive status epilepticus: a meta-analysis of published studies","volume":"23","author":"Yasiry","year":"2014","journal-title":"Seizure"},{"key":"2021070811475301300_fmab014-B22","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.seizure.2019.11.007","article-title":"Therapeutic effect of intravenous levetiracetam in status epilepticus: a meta-analysis and systematic review","volume":"74","author":"Chu","year":"2020","journal-title":"Seizure"},{"key":"2021070811475301300_fmab014-B23","article-title":"Levetiracetam for convulsive status epilepticus in childhood: systematic review and meta-analysis","author":"Abdelgadir","year":"2020","journal-title":"Arch Dis Child"},{"key":"2021070811475301300_fmab014-B24","doi-asserted-by":"crossref","first-page":"158","DOI":"10.4103\/JPN.JPN_126_17","article-title":"IV levetiracetam versus IV phenytoin in childhood seizures: a randomized controlled trial","volume":"13","author":"Singh","year":"2018","journal-title":"J Pediatr Neurosci"},{"key":"2021070811475301300_fmab014-B25","doi-asserted-by":"crossref","first-page":"237","DOI":"10.17511\/ijpr.2018.i04.13","article-title":"Randomized controlled trial of levetiracetam versus fosphenytoin for convulsive status epilepticus in children","volume":"5","author":"Senthil Kumar","year":"2018","journal-title":"Int J Pediatr Res."},{"key":"2021070811475301300_fmab014-B26","doi-asserted-by":"crossref","first-page":"2135","DOI":"10.1016\/S0140-6736(19)30722-6","article-title":"Levetiracetam versus phenytoin for second-line treatment of convulsive status epilepticus in children (ConSEPT): an open-label, multicentre, randomised controlled trial","volume":"393","author":"Dalziel","year":"2019","journal-title":"Lancet"},{"key":"2021070811475301300_fmab014-B27","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.1016\/S0140-6736(19)30724-X","article-title":"Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial","volume":"393","author":"Lyttle","year":"2019","journal-title":"Lancet"},{"key":"2021070811475301300_fmab014-B28","doi-asserted-by":"crossref","first-page":"2103","DOI":"10.1056\/NEJMoa1905795","article-title":"Randomized trial of three anticonvulsant medications for status epilepticus","volume":"381","author":"Kapur","year":"2019","journal-title":"N Engl J Med"},{"key":"2021070811475301300_fmab014-B29","doi-asserted-by":"crossref","first-page":"468","DOI":"10.3988\/jcn.2019.15.4.468","article-title":"Clinical efficacy and safety of injectable levetiracetam versus phenytoin as second-line therapy in the management of generalized convulsive status epilepticus in children: an open-label randomized controlled trial","volume":"15","author":"Noureen","year":"2019","journal-title":"J Clin Neurol"},{"key":"2021070811475301300_fmab014-B30","doi-asserted-by":"crossref","first-page":"3367","DOI":"10.4103\/jfmpc.jfmpc_750_19","article-title":"Levetiracetam versus phenytoin in children with status epilepticus","volume":"8","author":"Wani","year":"2019","journal-title":"J Family Med Prim Care"},{"key":"2021070811475301300_fmab014-B31","first-page":"741","article-title":"Levetiracetam versus phenytoin for treatment of convulsive status epilepticus in pediatric population: a randomized controlled trial","volume":"6","author":"Sharma"},{"key":"2021070811475301300_fmab014-B32","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1016\/S0140-6736(20)30611-5","article-title":"Efficacy of levetiracetam, fosphenytoin, and valproate for established status epilepticus by age group (ESETT): a double-blind, responsive-adaptive, randomised controlled trial","volume":"395","author":"Chamberlain","year":"2020","journal-title":"Lancet"},{"key":"2021070811475301300_fmab014-B33","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1007\/s13312-020-1755-4","article-title":"Comparison of phenytoin, valproate and levetiracetam in pediatric convulsive status epilepticus: a randomized double-blind controlled clinical trial","volume":"57","author":"Vignesh","year":"2020","journal-title":"Indian Pediatr"},{"key":"2021070811475301300_fmab014-B34","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1007\/s12098-020-03221-2","article-title":"Clinical effectiveness of levetiracetam compared to fosphenytoin in the treatment of benzodiazepine refractory convulsive status epilepticus","volume":"87","author":"Nalisetty","year":"2020","journal-title":"Indian J Pediatr"},{"key":"2021070811475301300_fmab014-B35","doi-asserted-by":"crossref","first-page":"252","DOI":"10.4103\/jpn.JPN_109_19","article-title":"Levetiracetam versus fosphenytoin in pediatric convulsive status epilepticus: a randomized controlled trial","volume":"15","author":"Handral","year":"2020","journal-title":"J Pediatr Neurosci"},{"key":"2021070811475301300_fmab014-B36","doi-asserted-by":"crossref","first-page":"b2700","DOI":"10.1136\/bmj.b2700","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration","volume":"339","author":"Liberati","year":"2009","journal-title":"BMJ"},{"key":"2021070811475301300_fmab014-B37","doi-asserted-by":"crossref","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"key":"2021070811475301300_fmab014-B38","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.seizure.2020.08.011","article-title":"Institutional Pediatric convulsive status epilepticus protocol decreases time to first and second line anti-seizure medication administration","volume":"81","author":"Trau","year":"2020","journal-title":"Seizure"},{"key":"2021070811475301300_fmab014-B39","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.pediatrneurol.2018.06.004","article-title":"Hospital emergency treatment of convulsive status epilepticus: comparison of pathways from ten pediatric research centers","volume":"86","author":"Vasquez","year":"2018","journal-title":"Pediatr Neurol"},{"key":"2021070811475301300_fmab014-B40","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/epi.12307","article-title":"Treatment of convulsive status epilepticus in childhood: recommendations of the Italian League Against Epilepsy","volume":"54 Suppl 7","author":"Capovilla","year":"2013","journal-title":"Epilepsia"}],"container-title":["Journal of Tropical Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/tropej\/article-pdf\/67\/2\/fmab014\/38496360\/fmab014.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/tropej\/article-pdf\/67\/2\/fmab014\/38496360\/fmab014.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T16:38:15Z","timestamp":1625762295000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/tropej\/article\/doi\/10.1093\/tropej\/fmab014\/6293813"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,1]]},"references-count":40,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,5,17]]}},"URL":"https:\/\/doi.org\/10.1093\/tropej\/fmab014","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2020.10.29.20222133","asserted-by":"object"}]},"ISSN":["0142-6338","1465-3664"],"issn-type":[{"value":"0142-6338","type":"print"},{"value":"1465-3664","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,4,1]]},"published":{"date-parts":[[2021,4,1]]},"article-number":"fmab014"}}