title: Low-dose levetiracetam for seizure prophylaxis after traumatic brain injury.
abstract: OBJECTIVE
  The primary objective of this study was to determine the effectiveness of a lower dose of levetiracetam (500 mg every 12 hours) to prevent early seizures after traumatic brain injury (TBI). It was hypothesized that the seizure rate would be low and comparable to previous studies using phenytoin.
  
  
  METHODS
  This was a retrospective cohort study conducted in a tertiary care, academic institution that is designated as a level 1 trauma centre in the US. Consecutive patients with TBI were evaluated. Patients who were given a levetiracetam dose of 500 mg every 12 hours were included. The primary outcome was the occurrence of a seizure within 7 days of TBI.
  
  
  RESULTS
  There were a total of 169 patients included in the study, who were treated with levetiracetam 500 mg every 12 hours. The median time to first dose of levetiracetam was 3.5 hours after injury (interquartile range = 1-13 hours). After initiation of levetiracetam, there were four (2.4%) patients who had a seizure within 7 days. This was not significantly different than the hypothesized population value of 3.6% (p = 0.390).
  
  
  CONCLUSIONS
  A lower dose of levetiracetam 500 mg every 12 hours after TBI may be effective for early seizure prevention after TBI.
authors.affiliation: a Department of Pharmacy Practice and Science , College of Pharmacy, The University of Arizona , Tucson , AZ , USA.
authors.forename: Asad E
authors.initials: AE
authors.lastname: Patanwala
authors.affiliation: a Department of Pharmacy Practice and Science , College of Pharmacy, The University of Arizona , Tucson , AZ , USA.
authors.forename: Alina
authors.initials: A
authors.lastname: Kurita
authors.affiliation: a Department of Pharmacy Practice and Science , College of Pharmacy, The University of Arizona , Tucson , AZ , USA.
authors.forename: Elaine
authors.initials: E
authors.lastname: Truong
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D000070642:Brain Injuries, Traumatic / Q000188:drug therapy*; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D010672:Phenytoin / Q000627:therapeutic use; D010889:Piracetam / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy*; D014193:Trauma Centers
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010672:Phenytoin; D010889:Piracetam
keywords: Anti-epileptic; critically ill; dosing; neurocritical care