Caffeine citrate: A review of its use in apnoea of prematurity

被引:83
作者
Comer A.M. [1 ]
Perry C.M. [1 ]
Figgitt D.P. [1 ]
机构
[1] Adis International Limited, Mairangi Bay, Auckland 10
来源
Paediatric Drugs | 2001年 / 3卷 / 1期
关键词
Caffeine; Theophylline; Aminophylline; Methylxanthine; Premature Neonate;
D O I
10.2165/00128072-200103010-00005
中图分类号
学科分类号
摘要
Apnoea of prematurity is a common condition in neonates born at less than 37 weeks' gestational age; it affects approximately 90% of premature neonates weighing under 1000g at birth, and 25% of infants with a birthweight of less than 2500g. Caffeine, a methylxanthine which occurs naturally in many plants, has been used for over 20 years to treat apnoea of prematurity. In a recent double-blind, placebo-controlled trial, apnoea was eliminated or reduced by at least 50% in significantly more neonates receiving caffeine citrate as first-line treatment than those receiving placebo. In a nonblind trial, caffeine citrate was more effective at reducing apnoeic episodes when compared with neonates receiving no treatment. Caffeine as first-line treatment demonstrated similar efficacy to theophylline or aminophylline (theophylline ethylenediamine) in 4 small randomised studies. Caffeine citrate was generally well tolerated in short term clinical trials, with very few adverse events reported. Caffeine was associated with fewer adverse events than theophylline in randomised trials. No differences in the incidence of individual adverse events were reported between caffeine citrate and placebo in a double-blind, randomised trial. Long term tolerability data are not yet available. Conclusions: Caffeine citrate was generally well tolerated by neonates in clinical trials and it decreased the incidence of apnoea of prematurity compared with placebo. It has demonstrated similar efficacy to theophylline, but is generally better tolerated and has a wider therapeutic index. Caffeine citrate should, therefore, be considered the drug of choice when pharmacological treatment of apnoea of prematurity is required.
引用
收藏
页码:61 / 79
页数:18
相关论文
共 93 条
  • [1] Grisemer A.N., Apnea of prematurity: Current management and nursing implications, Pediatr Nurs, 16, 6, pp. 606-611, (1990)
  • [2] Bhatia J., Current options in the management of apnea of prematurity, Clin Pediatr, 39, pp. 327-336, (2000)
  • [3] National Institutes of Health Consensus Development Conference on Infantile Apnea and Home Monitoring, Sep 29-Oct 1 1986, Pediatrics, 79, 2, pp. 292-299, (1987)
  • [4] Kriter K.E., Blanchard J., Management of apnea in infants, Clin Pharm, 8, 8, pp. 577-587, (1989)
  • [5] Spitzer A.R., Fox W.W., Infant apnea, Pediatr Clin North Am, 33, 3, pp. 561-581, (1986)
  • [6] Hascoet J.-M., Hamon I., Boutroy M.-J., Risks and benefits of therapies for apnoea in premature infants, Drug Saf, 23, 5, pp. 363-379, (2000)
  • [7] Tobias J.D., Caffeine in the treatment of apnea associated with respiratory syncytial virus infection in neonates and infants, South Med J, 93, 3, pp. 294-296, (2000)
  • [8] Behrman R.E., Kliegman R.M., Jenson H.B., Nelson textbook of pediatrics. 16th ed., (2000)
  • [9] Galinkin J.L., Kurth D., Neonatal and pediatric apnea syndromes, Prob Anesth, 10, 4, pp. 444-454, (1998)
  • [10] Eichenwald E.C., Aina A., Stark A.R., Apnea frequently persists beyond term gestation in infants delivered at 24 to 28 weeks, Pediatrics, 100, 3, pp. 354-359, (1997)