A systematic review compares efficacy and safety of levetiracetam and phenobarbital in treating neonatal seizures, implying potential for safer treatment options.
LEV and PB demonstrate comparable efficacy for first-line treatment of neonatal seizures; however, LEV provides a more favorable safety and tolerability profile, particularly with respect to cardiopulmonary stability. These findings support the consideration of LEV as an alternative first-line agent, especially in neonates at risk for hemodynamic or respiratory compromise. Further large, high-quality RCTs with standardized EEG confirmation and long-term neurodevelopmental follow-up are warranted.
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Moawad et al. (2026) studied this question.
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