{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T15:53:43Z","timestamp":1783698823238,"version":"3.55.0"},"reference-count":12,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T00:00:00Z","timestamp":1652140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study was undertaken to evaluate the efficacy, safety, and economic impact of diazepam suppositories with as\u2010needed acetaminophen in comparison with as\u2010needed acetaminophen alone for prevention of seizure recurrence during the same fever episode in suspected pediatric simple febrile seizures (SFS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single\u2010center, prospective, observational study was conducted from July 29, 2019 to February 15, 2021 at a children's hospital. Children aged 6\u00a0months to 60\u00a0months presenting to the emergency department with suspected SFS were included. Participants receiving both diazepam suppositories and as\u2010needed acetaminophen were compared with those receiving as\u2010needed acetaminophen alone. The primary outcome was seizure recurrence during the same fever episode. The secondary outcomes included the incidence of central nervous system (CNS) pathologies, adverse events, and medical costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 316 participants, 228 (72.2%) had their first febrile seizure. Diazepam (.3\u2013.5\u00a0mg\/kg for up to two doses) was administered to 88 of 316 patients (27.8%). The outcomes were available for 306 patients. The recurrence rate was 3.5% (3\/85) in the patients receiving diazepam with as\u2010needed acetaminophen and 12.2% (27\/221) in the patients receiving as\u2010needed acetaminophen alone (relative risk = .29, 95% confidence interval [CI] = .09\u2013.93, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.03). The adjusted odds ratio of diazepam administration against recurrence was .23 (95% CI = .07\u2013.78, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.02). None of the patients had a CNS pathology. No severe adverse events occurred, although mild ataxia was observed significantly more often in the patients receiving diazepam and as\u2010needed acetaminophen (29.4% vs. 18.7%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.04). The median medical cost was US $199 (interquartile range [IQR] = 86\u2013244) for the group receiving both medications and US $202 (IQR = 114\u2013242) for the group receiving as\u2010needed acetaminophen alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Compared with as\u2010needed acetaminophen alone, diazepam with as\u2010needed acetaminophen may reduce seizure recurrence more during the same fever episode without severe adverse events or additional costs in children with suspected SFS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.17271","type":"journal-article","created":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T14:06:07Z","timestamp":1651241167000},"page":"1704-1713","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Efficacy, safety, and economic impact of diazepam suppositories with as\u2010needed acetaminophen for prevention of seizure recurrence during the same fever episode in children with suspected simple febrile seizures"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1501-6633","authenticated-orcid":false,"given":"Miki","family":"Tanaka","sequence":"first","affiliation":[{"name":"Department of General Pediatrics Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9927-9253","authenticated-orcid":false,"given":"Qianzhi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Morikawa","sequence":"additional","affiliation":[{"name":"Clinical Research Support Center Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Tsukamoto","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Sammori","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Takehira","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mizuki","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Miyama","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saki","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazutoshi","family":"Narita","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics Tokyo Metropolitan Children's Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Kishibe","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Tokyo Metropolitan Children's Medical Center  Tokyo 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