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Evidence summaries

Routine Anticonvulsants for Treating Cerebral Malaria

Routine phenobarbitone in cerebral malaria may cause more deaths compared with placebo, although it is effective for convulsions. Level of evidence: "C"

A Cochrane review [Abstract] 1 included three trials (573 participants) comparing phenobarbitone with placebo or no treatment. In the two trials with adequate allocation concealment, death was more common in the anticonvulsant group (RR 2.0; 95% CI 1.20 to 3.33; fixed effect model, n=388). In all three trials, phenobarbitone compared with placebo or no treatment was associated with fewer convulsions (RR 0.30; 95% CI 0.19 to 0.45; fixed effect model).

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions, e.g. different doses of phenobarbitone and use of additional drugs) and by imprecise results (few patients and wide confidence intervals).

References

  • Meremikwu M, Marson AG. Routine anticonvulsants for treating cerebral malaria. Cochrane Database Syst Rev 2002;(2):CD002152. [PubMed]

Primary/Secondary Keywords