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Neurocritical Care

, Volume 7, Issue 2, pp 140–147 | Cite as

Levetiracetam use in critically ill patients

  • Jerzy P. SzaflarskiEmail author
  • Jason M. Meckler
  • Magdalena Szaflarski
  • Lori A. Shutter
  • Michael D. Privitera
  • Stephen L. Yates
Original Paper

Abstract

Introduction

Levetiracetam (LEV) is used in the setting of acute brain injury for seizure treatment or prophylaxis but its safety and efficacy in this setting is unknown.

Method

We retrospectively analyzed the patterns of use and safety/efficacy of LEV in 379 patients treated in the neuroscience intensive care unit (NSICU). We extracted from the charts clinical data including diagnosis, AED therapy before and during stay in the NSICU, complications of treatment, length of stay, and clinical outcomes (improvement, Glasgow Coma Scale, and death). We analyzed the data using binary and ordered (multi-category) logistic regression.

Results

Overall, our findings are that phenytoin used prior to the NSICU admission was frequently replaced with LEV monotherapy (P < 0.001). Patients treated with LEV monotherapy when compared to other AEDs had lower complication rates and shorter NSICU stays. Older patients and patients with brain tumors or strokes were preferentially treated with LEV for prevention and/or management of seizures (all P ≤ 0.014).

Discussion

The results of this study suggest that LEV is a frequently used AED in the setting of acute brain injury and that it may be a desirable alternative to phenytoin. Prospective studies evaluating the long-term safety, efficacy and outcomes of LEV in this setting are indicated.

Keywords

Levetiracetam (LEV) Stroke Hemorrhage Tumor ICU Outcome Epilepsy 

Notes

Acknowledgements/funding

Support for this study was provided by UCB, Inc. (UCB Young Investigator Research Project to Dr. Meckler); this work was presented in part at the American Epilepsy Society Annual Meeting in Washington, DC, 12/2005 and at the 7th European Congress of Epileptology, Helsinki, Finland, 7/2006. Drs. J.P. Szaflarski, Meckler, Shutter and Privitera received compensation for various activities sponsored by UCB Pharma. Dr. Yates is an employee of UCB, Inc.

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Copyright information

© Humana Press Inc. 2007

Authors and Affiliations

  • Jerzy P. Szaflarski
    • 1
    • 2
    • 3
    Email author
  • Jason M. Meckler
    • 1
  • Magdalena Szaflarski
    • 5
    • 6
  • Lori A. Shutter
    • 1
    • 3
    • 4
  • Michael D. Privitera
    • 1
    • 2
    • 3
  • Stephen L. Yates
    • 7
  1. 1.Department of NeurologyUniversity of Cincinnati Medical CenterCincinnatiUSA
  2. 2.Cincinnati Epilepsy CenterUniversity of Cincinnati Medical CenterCincinnatiUSA
  3. 3.The Neuroscience InstituteUniversity of Cincinnati Medical CenterCincinnatiUSA
  4. 4.Department of NeurosurgeryUniversity of Cincinnati Medical CenterCincinnatiUSA
  5. 5.Institute for the Study of HealthUniversity of Cincinnati Medical CenterCincinnatiUSA
  6. 6.Department of Family MedicineUniversity of Cincinnati Medical CenterCincinnatiUSA
  7. 7.UCB, Inc. Medical AffairsSmyrnaUSA

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