智利一家三级医院收治的 4 岁以下儿童的左乙拉西坦处方概况。

Pub Date : 2024-08-01 Epub Date: 2024-03-14 DOI:10.5546/aap.2023-10233.eng
Mónica Kyonen, Lily Acuña, Bárbara Ramos, Jocelyn Gutiérrez, R Mauricio Barría
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引用次数: 0

摘要

简介左乙拉西坦(LEV)是智利公共卫生研究所批准用于治疗 4 岁以上儿童癫痫发作的一种抗癫痫药物。然而,该药在新生儿期就被广泛使用,因此有必要对其标签外使用情况进行评估。目的确定智利南部一家三级医院在治疗 4 岁以下儿童癫痫发作时 LEV 的处方-适应症概况。人群和方法。观察性、描述性和回顾性研究。研究人员查阅了2014年至2019年期间开始使用LEV治疗的患者病历,并收集了社会人口学、药物学和临床变量数据。分析基于对患者概况、处方、随访和安全性的描述。结果共纳入 68 名患者:40例(58.8%)为男性,49例(72.1%)胎龄≥37周。癫痫的主要病因是结构性癫痫(35.3%);LEV主要用于确诊为中枢神经系统畸形的儿童(17.6%),单药治疗是主要用药方式(55.9%)。50%的病例使用 LEV 治疗局灶性癫痫发作。5名儿童(7.3%)患有精神疾病,被归类为可能的药物不良反应。结论LEV用于各种诊断的儿童,不良反应发生率较低。不同年龄组的用药情况各不相同。今后需要进行研究,以确定其有效性,尤其是对新生儿和难治性癫痫患者的有效性。
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Levetiracetam prescription profile in children younger than 4 years treated at a tertiary care hospital in Chile.

Introduction. Levetiracetam (LEV) is an antiepileptic drug approved by the Chilean Institute of Public Health as concomitant therapy for epileptic seizures in children older than 4 years of age. However, it is widely prescribed from the neonatal period, which makes it necessary to evaluate its off-label use. Objective. To determine the prescription-indication profile of LEV in the treatment of epileptic seizures in children younger than 4 years in a tertiary care hospital in southern Chile. Population and method. Observational, descriptive, and retrospective study. The medical records of patients who started treatment with LEV between 2014 and 2019 were reviewed, and data on sociodemographic, pharmacological, and clinical variables were collected. The analysis was based on the description of the profile of patients, prescriptions, follow-up, and safety. Results. A total of 68 patients were included: 40 (58.8%) were males, 49 (72.1%) were born at a gestational age ≥ 37 weeks. The main etiology of epilepsy was structural (35.3%); LEV was mostly used in children diagnosed with central nervous system malformation (17.6%), and monotherapy was the prevailing dosage (55.9%). LEV was used for focal seizures in 50% of cases. Five children (7.3%) had psychiatric disorders, classified as probable adverse drug reactions. Conclusion. LEV was used in children with various diagnoses, with a low rate of adverse events. The profile of drug use varied in the different age groups. Future studies are needed to identify effectiveness, especially in newborn infants and patients with refractory epilepsy.

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