Comparing the Effectiveness and Safety of Intravenous Levetiracetam and Phenobarbital as First-Line Therapies for Neonatal Seizures: A Randomized Clinical Trial

Objectives This randomized clinical trial aims to evaluate and compare phenobarbital and levetiracetam effectiveness and safety in controlling neonatal seizures as first-line therapeutic options. Materials & Methods Neonates with seizure manifestations presenting to the Bahrami Hospital from March 2020 to March 2022 were enrolled in this study. Patients' data were recorded, including demographic findings, anthropometric measurements, birth characteristics, and laboratory findings. Patients were randomly divided into the phenobarbital and levetiracetam treatment groups. Outcomes defined as adverse effects, response to medication, time to start enteral feeding, and length of hospital stay were compared between the two treatment groups. Results The current study comprises 44 neonates divided into phenobarbital and levetiracetam groups. Seizure control among the two groups was not significantly different, with levetiracetam and phenobarbital groups showing seizure control of 68.2% and 59.1%, respectively. Moreover, no significant difference was observed regarding the duration of hospitalization and time to initiate feeding. No adverse effect was reported in either group. Conclusion This study showed no significant difference between levetiracetam and phenobarbital for neonatal seizure control.