What do systematic reviews say?

Intravenous midazolam vs intravenous diazepam

Summary of findings ‐ Intravenous midazolam showed no clear difference in seizure cessation 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 1.08 [0.97, 1.21]
  1 study · 80 participants
  Moderate

Intravenous midazolam vs intravenous lorazepam

Summary of findings ‐ Intravenous midazolam showed no clear difference in seizure cessation compared with intravenous lorazepam (moderate certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.98 [0.91, 1.04]
  1 study · 80 participants
  Moderate

Summary of findings ‐ Buccal midazolam vs intravenous diazepam

Summary of findings ‐ Buccal midazolam showed no clear difference in seizure cessation compared with intravenous diazepam (high certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.91 [0.8, 1.03]
  1 study · 120 participants
  High

Summary of findings ‐ Intranasal midazolam vs intravenous diazepam

Summary of findings ‐ Intranasal midazolam showed no clear difference in seizure cessation 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 0.98 [0.91, 1.06]
  2 studies · 122 participants
  Moderate

Summary of findings ‐ Intramuscular midazolam vs intravenous diazepam

Summary of findings ‐ Intramuscular midazolam showed no clear difference in seizure cessation compared with intravenous diazepam (low certainty).

• Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children 2018 · Cochrane Headline outcomes only
  RR 0.97 [0.87, 1.09]
  2 studies · 105 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
  Very low