Comparison of Safety and Effectiveness between Levetiracetam and Phenytoin in the Treatment of Pediatric Status Epilepticus: A Meta-Analysis

Objective: To evaluate the safety and effectiveness of levetiracetam and phenytoin by evaluating the events of seizure termination and recurrence in children. Methods: We used the internet databases PubMed, Embase, and Google Scholar to conduct a literature search for the appropriate studies. A meta-analysis was performed to calculate the odds ratio using fixed and random-effects models. Results: We identified 15 studies that were eligible for the meta-analysis. The incidence of seizure termination within 24 h was 76.9% for levetiracetam and 70.5% for phenytoin. Levetiracetam had a higher number of seizure termination events than phenytoin (P = 0.005, I² = 66%). The incidence of seizure recurrence within 24 h was 10% for levetiracetam and 15.6% for phenytoin. Phenytoin had a significantly higher number of seizure recurrence events than levetiracetam (P = 0.00007, I² = 21%). Conclusion: The efficacy and safety of levetiracetam are superior to that of phenytoin in children with status epilepticus. Large Randomized Controlled Trial studies are needed to confirm the result in children.