Comparison of the efficacy of Clofibrate with Phenobarbital in decreasing neonatal hyperbilirubinemia

Background: Hyperbilirubinemia is a common problem in newborn infants. It can progress to kernicterus in severe forms, unless an intervention is initiated. The objective of this study was to compare the efficacy of Clofibrate with Phenobarbital in full-term neonates with nonhemolytic jaundice. Methods: this double blind clinical trial study was performed on 60 neonate who were divided randomly in two groups of full-term jaundiced neonates: the clofibrate-treated group (n = 30) and the Phenobarbital group (n = 30). Infants in the clofibrate group received a single oral dose of 100 mg.kg clofibrate while the neonates in the Phenobarbital group received a single oral dose of 5 mg.kg Phenobarbital; both groups received phototherapy. Total serum and direct bilirubin levels were measured at the beginning, 12 and 24 hours after the initiation of treatment. Results: The mean +/- SD total serum bilirubin level of the Phenobarbital group and clofibrate groups at enrollment was 17.84 +/- 1.017 and 18.04 +/- 0.852 mg.dL, respectively. The mean +/- SD total serum bilirubin in Phenobarbital group and clofibrate groups after 24 hours was 11.11 +/- 1.273 and 12.55 +/- 1.008 mg.dL, respectively (P = 0.000). After 72 hours of intervention, 25 (83%) neonates of the Phenobarbital group and 23 (76%) of the clofibrate group were discharged with a total serum bilirubin of <10 mg.dL (P = 0.000). No side-effect was observed on serial examination during hospitalization, and on the first and seventh day after discharge. Conclusion: Phenobarbital in the compared with clofibrate results in a faster decline in total serum bilirubin, shorter duration of hospitalization and had no side effects in jaundiced full-term neonates.