Midazolam for Treating Severe Malaria and Convulsions in Children
Author Information
Author(s): Muchohi Simon N, Kokwaro Gilbert O, Ogutu Bernhards R, Edwards Geoffrey, Ward Steve A, Newton Charles R J C
Primary Institution: Kenya Medical Research Institute (KEMRI)/Wellcome Trust Research Programme
Hypothesis
To investigate the pharmacokinetics and clinical efficacy of intravenous (IV), intramuscular (IM) and buccal midazolam (MDZ) in children with severe falciparum malaria and convulsions.
Conclusion
IV administration of midazolam is more effective in terminating convulsions than IM and buccal routes, but it carries a risk of respiratory depression.
Supporting Evidence
- A single dose of MDZ terminated convulsions in all (100%), 9/12 (75%), and 5/8 (63%) children following IV, IM, and buccal administration, respectively.
- Median plasma MDZ Cmax values were achieved within 10 to 15 minutes after administration.
- Four children experienced respiratory depression after MDZ administration.
Takeaway
This study looked at how well midazolam works to stop seizures in kids with severe malaria. It found that giving it through an IV works best, but it can also cause breathing problems.
Methodology
Thirty-three children with severe malaria and convulsions were given a single dose of MDZ via IV, IM, or buccal routes, and blood samples were collected to analyze plasma concentrations.
Potential Biases
Potential selection bias due to non-randomized design.
Limitations
The study was non-randomized and had small sample sizes in each group, which may limit the comparison between the groups.
Participant Demographics
Children aged 6 months to 13 years with severe malaria and convulsions.
Statistical Information
P-Value
<0.05
Confidence Interval
95% CI provided for various pharmacokinetic parameters.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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