Pharmacokinetics and clinical efficacy of midazolam in children with severe malaria and convulsions
2008

Midazolam for Treating Severe Malaria and Convulsions in Children

Sample size: 33 publication 10 minutes Evidence: moderate

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)

10.1111/j.1365-2125.2008.03239.x

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