Neuroanesthesia & neurocritical care
Optimal Dosing of Levetiracetam for Seizure Prophylaxis in Critically Ill Patients: A Prospective Observational Study
Authors' conclusion
Underdosing of LEV was common, with only 54% of patients achieving target serum levels. Higher doses (750-1,000 mg bid) were more than twice as likely to lead to optimal drug levels and reduced the odds of seizure by 68% compared with low-dose regimens (500 mg bid).
Study context
- Population
- Critically ill patients receiving prophylactic levetiracetam (LEV) after TBI, intracerebral hemorrhage, spontaneous SAH or supratentorial neurosurgery, 2019–2021; excluding prior seizure, antiseizure medication use or renal failure requiring dialysisincluded in analyses
- Participants
- 205 patients
- Exposure
- High-dose vs low-dose prophylactic levetiracetam
- High-dosen = 99
- Low-dosen = 106reference
- Outcome
- Target LEV levels (12-46 μg/mL) at steady state
Methodological detailssingle-centre, multivariable logistic regression
- Single-centre
- Multivariable logistic regression
Main finding
As reported in the abstract
Target LEV levels
High-dose vs Low-doseEstimate (95% CI)P value
Target LEV levels
OR 2.1(1.1–3.7)
P = 0.009Adjusted for age, loading dose, BMI, diagnosis, CrCl
aOR 2.23(1.16–4.27)
P = 0.016- Overall achieved target levels
- 111 of 205 (54%)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Clinical and/or electrographic seizureAdjusted for age, loading dose, BMI, diagnosis, CrCl | 0.32 (0.13–0.82) | P = 0.018 | |
| 0.10.31310Adjusted odds ratio (log scale) |
Original publication
Optimal Dosing of Levetiracetam for Seizure Prophylaxis in Critically Ill Patients: A Prospective Observational Study. Crit Care Med. Published 20 September 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →