What do systematic reviews say?

Summary of findings ‐ Intravenous lorazepam vs intravenous diazepam/intravenous phenytoin combination

Summary of findings ‐ Intravenous lorazepam showed no clear difference in incidence of respiratory depression compared with intravenous diazepam/intravenous phenytoin combination (moderate certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.78 [0.22, 2.82]
  1 study · 178 participants
  Moderate

Summary of findings ‐ Buccal midazolam vs rectal diazepam

Summary of findings ‐ Buccal midazolam showed no clear difference in incidence of respiratory depression compared with rectal diazepam (low certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.88 [0.61, 1.25]
  4 studies · 648 participants
  Low

Benzodiazepines (lorazepam) vs diazepam

Summary of findings ‐ Lorazepam probably leads to lower incidence of respiratory depression compared with diazepam (moderate certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.72 [0.55, 0.93]
  3 studies · 439 participants
  Moderate

Summary of findings ‐ Buccal midazolam vs intravenous diazepam

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 120 participants
  High

Summary of findings ‐ Intranasal midazolam vs intravenous diazepam

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 122 participants
  High

Summary of findings ‐ Intranasal midazolam vs rectal diazepam

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 45 participants
  Low

Summary of findings ‐ Intramuscular midazolam vs intravenous diazepam

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 105 participants
  Low

Summary of findings ‐ Intramuscular midazolam vs rectal diazepam

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 100 participants
  Moderate

Intravenous midazolam vs intravenous diazepam

Summary of findings ‐ Intravenous midazolam showed no clear difference in incidence of respiratory depression compared with intravenous diazepam (moderate certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.33 [0.01, 7.95]
  1 study · 80 participants
  Moderate