Efficacy of a diazepam suppository at preventing febrile seizure recurrence during a single febrile illness

Hirabayashi, Yu; Okumura, Akihisa; Kondo, Teruyoshi; Magota, Miyuki; Kawabe, Shinji; Kando, Naoyuki; Yamaguchi, Hideaki; Natsume, Jun; Negoro, Tamiko; Watanabe, Kazuyoshi

doi:10.1016/j.braindev.2008.07.010

Cited by 25 publications

(22 citation statements)

References 18 publications

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“…However, the treatment may suppress subsequent clustered seizures in the FS group. The effective rate of DZP for the cessation of seizures in the FS group was also 75%, which was lower than that in febrile seizures in general (Hirabayashi et al, 2009). Therefore the results indicate that the seizures in the FS group may have a different pathogenesis from the febrile seizures due to other causes, with respect to the frequency of clustered seizures and the efficacy of DZP.…”

Section: Discussioncontrasting

confidence: 69%

“…Febrile seizures are further classified as simple or complex, with the latter exhibiting one or more of the following features: partial onset, prolonged duration, or multiple seizures within 24 h. Previous investigations reported that multiple seizures in a febrile illness ranged from 18.4% to 41.2% for the complex type, whereby multiple seizures constituted 8.5-19.9% of febrile seizures (Berg and Shinnar, 1996;Nelson and Ellenberg, 1983;Simizu et al, 2008). Rectal DZP is useful for suppressing the recurrence of febrile seizures, with an effective rate of 85.2%, as reported by Hirabayashi (Hirabayashi et al, 2009).…”

Section: Discussionmentioning

confidence: 68%

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Clinical characteristics of seizures associated with viral gastroenteritis in children

et al. 2015

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Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 68%

Clinical characteristics of seizures associated with viral gastroenteritis in children

et al. 2015

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“…First, a diazepam suppository was by far the most commonly used for inpatients with FS in Japan. This is because most physicians in Japan expect the effects of slowly absorbed benzodiazepine suppository on preventing subsequent seizure recurrence [20]. Second, intravenous benzodiazepines slightly increased over the period.…”

Section: Discussionmentioning

confidence: 99%

Recent practice patterns in diagnostic procedures anticonvulsants, and antibiotics for children hospitalized with febrile seizure

Okubo

Hayakawa

Nariai

et al. 2019

Seizure

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A B S T R A C TPurpose This study investigated clinical practice patterns for admissions due to FS at a national level.Method Discharge records were extracted for patients with FS aged < 6 years for the years 2010-16 using national inpatient database in Japan. We ascertained antiepileptic drug use, diagnostic procedures, healthcare costs, and length of hospital stays (LOS), using mixed effect linear or logistic regression models. We also investigated correlations between performance of lumbar puncture (LP), and use of head computed tomography (CT) and antibiotics.Results We identified a total of 94,452 eligible patients. Hospitalization costs and LOS in days decreased from 19,027 JPY and 4.6 days in 2010 to 18,753 JPY and 4.1 days in 2016. Phenytoin use decreased from 1.6% in 2010 to 0.5% in 2016, whereas fosphenytoin use increased from 0% in 2010 to 6.7% in 2016. Decreasing trends were observed in CT use (from 32.8% to 16.9%) and LP performance (16.9% to 13.5%). For the analyses at hospital levels, CT use and LP performance was positively correlated (r = 0.63). No correlations were observed between total and extremely broad-spectrum antibiotic use and CT use or LP performance in hospitals without cases of intensive care. Wide variations were observed across hospitals for performance of LP (0%-88%), use of CT (0%-84%) and antibiotics (10%-99%).Conclusion We provided novel insights into the current practice patterns for children with FS at individual levels, and delineated wide variations of LP, CT, and antibiotic use for the practices at hospital levels.

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“…However, this route of administration required skilled medical personnel and can result in serious adverse effects. Alternatively, the rectal administration of diazepam has been shown to be clinically effective in the treatment of seizures and the prevention of febrile recurrent convulsions (1,3). Due to its practical insolubility in water, a major obstacle of the rectal formulation generally is a limited solubility of drug in a very small volume of rectal fluid.…”

Section: Introductionmentioning

confidence: 99%

Development and Characterization of Lyophilized Diazepam-Loaded Polymeric Micelles

et al. 2013

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Abstract. Polymeric micelles were studied as delivery carriers of diazepam, a practically insoluble drug in water, for rectal administration. The diazepam-loaded polymeric micelles were developed by using poloxamer 407 (P407), poloxamer 188, and D-α-tocopheryl poly(ethylene glycol) 1000 succinate (TPGS). Among the used polymers, TPGS resulted in polymeric micelles with good characteristics for encapsulation of diazepam which had the small particle size of 8-12 nm and narrow size distribution (PI 0.053-0.275). Additionally, 7.5%w/v of TPGS could entirely entrap the desired concentration of diazepam (5 mg/mL). To improve the physical stability upon lyophilization, an addition of P407 of 1%w/v prevented aggregation, increased physical stability, and maintained chemical stability of the lyophilized powders of diazepam-loaded polymeric micelles for 3 months storage at 4°C. The rate and amount of diazepam release from TPGS polymeric micelles mainly depended on the concentration of TPGS. The release data were fitted to Higuchi's model suggesting that the drug release mechanism was controlled by Fickian diffusion. In conclusion, 10%w/v TPGS and 1%w/v P407 were the optimum formulation of lyophilized diazepam-loaded polymeric micelles.

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Efficacy of a diazepam suppository at preventing febrile seizure recurrence during a single febrile illness

Cited by 25 publications

References 18 publications

Clinical characteristics of seizures associated with viral gastroenteritis in children

Clinical characteristics of seizures associated with viral gastroenteritis in children

Recent practice patterns in diagnostic procedures anticonvulsants, and antibiotics for children hospitalized with febrile seizure

Development and Characterization of Lyophilized Diazepam-Loaded Polymeric Micelles

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