Cochrane · systematic review · CD003031
Prophylactic drug management for febrile seizures in children
Offringa, M, Newton, R, Nevitt, SJ, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
105
current version
GRADE rated
39
No studies
66
Included studies
NR
No studies 66 · 62.9%Ungraded 0 · 0%Very low 9 · 8.6%Low 14 · 13.3%Moderate 7 · 6.7%High 9 · 8.6%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Show all 3 versionsIntermittent oral or rectal diazepam compared to placebo or no treatment for febrile seizures in children
Population: children with febrile seizures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent seizure at 6 months Intermittent oral or rectal diazepam vs placebo or no treatment | RR 0.64 [0.48, 0.85] | 6 studies · 1151 participants | Moderate Downgraded: risk of bias |
Recurrent seizure at 12 months Intermittent oral or rectal diazepam vs placebo or no treatment | RR 0.69 [0.56, 0.84] | 8 studies · 1416 participants | Moderate Downgraded: risk of bias |
Recurrent seizure at 18 months Intermittent oral or rectal diazepam vs placebo or no treatment | RR 0.37 [0.23, 0.6] | 1 study · 289 participants | Low Downgraded: risk of bias |
Recurrent seizure at 24 months Intermittent oral or rectal diazepam vs placebo or no treatment | RR 0.73 [0.56, 0.95] | 4 studies · 739 participants | High |
Recurrent seizure at 36 months Intermittent oral or rectal diazepam vs placebo or no treatment | RR 0.58 [0.4, 0.85] | 1 study · 139 participants | Low Downgraded: risk of bias |
Recurrent seizure at 48 months Intermittent oral or rectal diazepam vs placebo or no treatment | RR 0.36 [0.15, 0.89] | 1 study · 110 participants | Moderate Downgraded: risk of bias |
Recurrent seizure at 60 months or greater Intermittent oral or rectal diazepam vs placebo or no treatment | RR 0.08 [0, 1.31] | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision |
Continuous phenobarbital compared to placebo or no treatment for febrile seizures in children
Population: children with febrile seizures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent seizure at 6 months Continuous phenobarbital vs placebo or no treatment | RR 0.59 [0.42, 0.83] | 6 studies · 833 participants | Moderate Downgraded: risk of bias |
Recurrent seizure at 12 months Continuous phenobarbital vs placebo or no treatment | RR 0.54 [0.42, 0.7] | 7 studies · 807 participants | Low Downgraded: risk of bias, publication bias |
Recurrent seizure at 18 months Continuous phenobarbital vs placebo or no treatment | RR 0.77 [0.56, 1.05] | 2 studies · 264 participants | Moderate Downgraded: risk of bias |
Recurrent seizure at 24 months Continuous phenobarbital vs placebo or no treatment | RR 0.69 [0.53, 0.89] | 3 studies · 533 participants | Moderate Downgraded: risk of bias |
Recurrent seizure at 36 months Continuous phenobarbital vs placebo or no treatment | no estimate extracted | NR | No studies |
Recurrent seizure at 48 months Continuous phenobarbital vs placebo or no treatment | no estimate extracted | NR | No studies |
Recurrent seizure at 60 months or greater Continuous phenobarbital vs placebo or no treatment | RR 1.5 [0.61, 3.69] | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision |
Intermittent phenobarbital compared to placebo or no treatment for febrile seizures in children
Population: children with febrile seizures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent seizure at 6 months Intermittent phenobarbital vs placebo or no treatment | RR 1.37 [0.67, 2.81] | 2 studies · 281 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Recurrent seizure at 12 months Intermittent phenobarbital vs placebo or no treatment | RR 1.01 [0.65, 1.59] | 2 studies · 281 participants | Moderate Downgraded: risk of bias |
Recurrent seizure at 18 months Intermittent phenobarbital vs placebo or no treatment | no estimate extracted | NR | No studies |
Recurrent seizure at 24 months Intermittent phenobarbital vs placebo or no treatment | RR 0.85 [0.57, 1.28] | 1 study · 249 participants | Low Downgraded: risk of bias |
Recurrent seizure at 36 months Intermittent phenobarbital vs placebo or no treatment | no estimate extracted | NR | No studies |
Recurrent seizure at 48 months Intermittent phenobarbital vs placebo or no treatment | no estimate extracted | NR | No studies |
Recurrent seizure at 60 months or greater Intermittent phenobarbital vs placebo or no treatment | RR 0.83 [0.28, 2.44] | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision |
Continuous oral phenytoin compared to placebo for febrile seizures in children
Population: children with febrile seizures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent seizure at 6 months Continuous oral phenytoin vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 12 months Continuous oral phenytoin vs placebo | RR 0.98 [0.55, 1.73] | 1 study · 90 participants | Low Downgraded: risk of bias |
Recurrent seizure at 18 months Continuous oral phenytoin vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 24 months Continuous oral phenytoin vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 36 months Continuous oral phenytoin vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 48 months Continuous oral phenytoin vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 60 months or greater Continuous oral phenytoin vs placebo | no estimate extracted | NR | No studies |
Continuous oral valproate compared to placebo or no treatment for febrile seizures in children
Population: children with febrile seizures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent seizure at 6 months Continuous oral valproate vs placebo or no treatment | RR 1.2 [0.55, 2.62] | 2 studies · 156 participants | Low Downgraded: risk of bias |
Recurrent seizure at 12 months Continuous oral valproate vs placebo or no treatment | RR 0.82 [0.52, 1.29] | 4 studies · 255 participants | Low Downgraded: risk of bias |
Recurrent seizure at 18 months Continuous oral valproate vs placebo or no treatment | RR 0.13 [0.02, 0.96] | 1 study · 48 participants | Very low Downgraded: risk of bias, imprecision |
Recurrent seizure at 24 months Continuous oral valproate vs placebo or no treatment | RR 1.26 [0.73, 2.18] | 2 studies · 156 participants | Low Downgraded: risk of bias |
Recurrent seizure at 36 months Continuous oral valproate vs placebo or no treatment | no estimate extracted | NR | No studies |
Recurrent seizure at 48 months Continuous oral valproate vs placebo or no treatment | no estimate extracted | NR | No studies |
Recurrent seizure at 60 months or greater Continuous oral valproate vs placebo or no treatment | no estimate extracted | NR | No studies |
Continuous oral pyridoxine compared to placebo for febrile seizures in children
Population: children with febrile seizures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent seizure at 6 months Continuous oral pyridoxine vs placebo | RR 0.47 [0.15, 1.48] | 1 study · 107 participants | Low Downgraded: risk of bias, imprecision |
Recurrent seizure at 12 months Continuous oral pyridoxine vs placebo | RR 0.66 [0.27, 1.61] | 1 study · 107 participants | Low Downgraded: risk of bias, imprecision |
Recurrent seizure at 18 months Continuous oral pyridoxine vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 24 months Continuous oral pyridoxine vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 36 months Continuous oral pyridoxine vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 48 months Continuous oral pyridoxine vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 60 months or greater Continuous oral pyridoxine vs placebo | no estimate extracted | NR | No studies |
Intermittent oral ibuprofen compared to placebo for febrile seizures in children
Population: children with febrile seizures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent seizure at 6 months Intermittent oral ibuprofen vs placebo | RR 1.11 [0.69, 1.81] | 1 study · 230 participants | High |
Recurrent seizure at 12 months Intermittent oral ibuprofen vs placebo | RR 0.95 [0.63, 1.43] | 1 study · 230 participants | High |
Recurrent seizure at 18 months Intermittent oral ibuprofen vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 24 months Intermittent oral ibuprofen vs placebo | RR 0.84 [0.59, 1.19] | 1 study · 230 participants | High |
Recurrent seizure at 36 months Intermittent oral ibuprofen vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 48 months Intermittent oral ibuprofen vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 60 months or greater Intermittent oral ibuprofen vs placebo | no estimate extracted | NR | No studies |
Intermittent oral clobazam compared to placebo for febrile seizures in children
Population: children with febrile seizures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent seizure at 6 months Intermittent oral clobazam vs placebo | RR 0.36 [0.2, 0.64] | 1 study · 60 participants | Low Downgraded: risk of bias, indirectness |
Recurrent seizure at 12 months Intermittent oral clobazam vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 18 months Intermittent oral clobazam vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 24 months Intermittent oral clobazam vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 36 months Intermittent oral clobazam vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 48 months Intermittent oral clobazam vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 60 months or greater Intermittent oral clobazam vs placebo | no estimate extracted | NR | No studies |
Continuous zinc sulfate for 6 months compared to placebo for febrile seizures in children
Population: children with febrile seizures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent seizure at 6 months Continuous zinc sulfate for 6 months vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 12 months Continuous zinc sulfate for 6 months vs placebo | RR 0.58 [0.31, 1.09] | 1 study · 100 participants | High |
Recurrent seizure at 18 months Continuous zinc sulfate for 6 months vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 24 months Continuous zinc sulfate for 6 months vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 36 months Continuous zinc sulfate for 6 months vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 48 months Continuous zinc sulfate for 6 months vs placebo | no estimate extracted | NR | No studies |
Recurrent seizure at 60 months or greater Continuous zinc sulfate for 6 months vs placebo | no estimate extracted | NR | No studies |
Intermittent rectal diclofenac compared to placebo, followed by oral ibuprofen, paracetamol, or placebo after 8 hours, for febrile seizures in children
Population: children with febrile seizures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent seizure at 6 months Intermittent rectal diclofenac vs placebo, followed by oral ibuprofen, paracetamol, or placebo after 8 hours, | RR 0.8 [0.42, 1.55] | 1 study · 231 participants | High |
Recurrent seizure at 12 months Intermittent rectal diclofenac vs placebo, followed by oral ibuprofen, paracetamol, or placebo after 8 hours, | RR 0.69 [0.4, 1.16] | 1 study · 231 participants | High |
Recurrent seizure at 18 months Intermittent rectal diclofenac vs placebo, followed by oral ibuprofen, paracetamol, or placebo after 8 hours, | RR 0.72 [0.45, 1.16] | 1 study · 231 participants | High |
Recurrent seizure at 24 months Intermittent rectal diclofenac vs placebo, followed by oral ibuprofen, paracetamol, or placebo after 8 hours, | RR 0.79 [0.51, 1.24] | 1 study · 231 participants | High |
Recurrent seizure at 36 months Intermittent rectal diclofenac vs placebo, followed by oral ibuprofen, paracetamol, or placebo after 8 hours, | no estimate extracted | NR | No studies |
Recurrent seizure at 48 months Intermittent rectal diclofenac vs placebo, followed by oral ibuprofen, paracetamol, or placebo after 8 hours, | no estimate extracted | NR | No studies |
Recurrent seizure at 60 months or greater Intermittent rectal diclofenac vs placebo, followed by oral ibuprofen, paracetamol, or placebo after 8 hours, | no estimate extracted | NR | No studies |
Continuous phenobarbital compared to intermittent rectal or oral diazepam for febrile seizures in children
Population: children with febrile seizures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent seizure at 6 months Continuous phenobarbital vs intermittent rectal or oral diazepam | no estimate extracted | NR | No studies |
Recurrent seizure at 12 months Continuous phenobarbital vs intermittent rectal or oral diazepam | RR 1.48 [0.75, 2.94] | 1 study · 145 participants | Low Downgraded: risk of bias |
Recurrent seizure at 18 months Continuous phenobarbital vs intermittent rectal or oral diazepam | RR 1.25 [0.36, 4.38] | 1 study · 100 participants | Very low Downgraded: risk of bias, imprecision |
Recurrent seizure at 24 months Continuous phenobarbital vs intermittent rectal or oral diazepam | no estimate extracted | NR | No studies |
Recurrent seizure at 36 months Continuous phenobarbital vs intermittent rectal or oral diazepam | no estimate extracted | NR | No studies |
Recurrent seizure at 48 months Continuous phenobarbital vs intermittent rectal or oral diazepam | no estimate extracted | NR | No studies |
Recurrent seizure at 60 months or greater Continuous phenobarbital vs intermittent rectal or oral diazepam | no estimate extracted | NR | No studies |
Intermittent rectal diazepam compared to intermittent rectal valproate for febrile seizures in children
Population: children with febrile seizures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent seizure at 6 months Intermittent rectal diazepam vs intermittent rectal valproate | RR 1.41 [0.58, 3.47] | 1 study · 169 participants | Very low Downgraded: risk of bias, imprecision |
Recurrent seizure at 12 months Intermittent rectal diazepam vs intermittent rectal valproate | RR 1.48 [0.82, 2.67] | 1 study · 169 participants | Low Downgraded: risk of bias |
Recurrent seizure at 18 months Intermittent rectal diazepam vs intermittent rectal valproate | no estimate extracted | NR | No studies |
Recurrent seizure at 24 months Intermittent rectal diazepam vs intermittent rectal valproate | no estimate extracted | NR | No studies |
Recurrent seizure at 36 months Intermittent rectal diazepam vs intermittent rectal valproate | no estimate extracted | NR | No studies |
Recurrent seizure at 48 months Intermittent rectal diazepam vs intermittent rectal valproate | no estimate extracted | NR | No studies |
Recurrent seizure at 60 months or greater Intermittent rectal diazepam vs intermittent rectal valproate | no estimate extracted | NR | No studies |
Intermittent oral diazepam compared to intermittent oral clobazam for febrile seizures in children
Population: children with febrile seizures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent seizure at 6 months Intermittent oral diazepam vs intermittent oral clobazam | no estimate extracted | NR | No studies |
Recurrent seizure at 12 months Intermittent oral diazepam vs intermittent oral clobazam | RR 2.28 [0.62, 8.42] | 2 studies · 143 participants | Low Downgraded: risk of bias, imprecision |
Recurrent seizure at 18 months Intermittent oral diazepam vs intermittent oral clobazam | no estimate extracted | NR | No studies |
Recurrent seizure at 24 months Intermittent oral diazepam vs intermittent oral clobazam | no estimate extracted | NR | No studies |
Recurrent seizure at 36 months Intermittent oral diazepam vs intermittent oral clobazam | no estimate extracted | NR | No studies |
Recurrent seizure at 48 months Intermittent oral diazepam vs intermittent oral clobazam | no estimate extracted | NR | No studies |
Recurrent seizure at 60 months or greater Intermittent oral diazepam vs intermittent oral clobazam | no estimate extracted | NR | No studies |
Intermittent oral melatonin compared to intermittent oral diazepam for febrile seizures in children
Population: children with febrile seizures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent seizures at 6 months Intermittent oral melatonin vs intermittent oral diazepam | no estimate extracted | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision |
Recurrent seizures at 12 months Intermittent oral melatonin vs intermittent oral diazepam | no estimate extracted | NR | No studies |
Recurrent seizures at 18 months Intermittent oral melatonin vs intermittent oral diazepam | no estimate extracted | NR | No studies |
Recurrent seizures at 24 months Intermittent oral melatonin vs intermittent oral diazepam | no estimate extracted | NR | No studies |
Recurrent seizures at 36 months Intermittent oral melatonin vs intermittent oral diazepam | no estimate extracted | NR | No studies |
Recurrent seizures at 48 months Intermittent oral melatonin vs intermittent oral diazepam | no estimate extracted | NR | No studies |
Recurrent seizures at 60 months or greater Intermittent oral melatonin vs intermittent oral diazepam | no estimate extracted | NR | No studies |
Intermittent oral levetiracetam compared to placebo (any antipyretics) for febrile seizures in children
Population: children with febrile seizures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent seizures at 6 months Intermittent oral levetiracetam vs placebo (any antipyretics) | no estimate extracted | NR | No studies |
Recurrent seizures at 12 months Intermittent oral levetiracetam vs placebo (any antipyretics) | RR 0.27 [0.15, 0.52] | 1 study · 115 participants | Very low Downgraded: risk of bias |
Recurrent seizures at 18 months Intermittent oral levetiracetam vs placebo (any antipyretics) | no estimate extracted | NR | No studies |
Recurrent seizures at 24 months Intermittent oral levetiracetam vs placebo (any antipyretics) | no estimate extracted | NR | No studies |
Recurrent seizures at 36 months Intermittent oral levetiracetam vs placebo (any antipyretics) | no estimate extracted | NR | No studies |
Recurrent seizures at 48 months Intermittent oral levetiracetam vs placebo (any antipyretics) | no estimate extracted | NR | No studies |
Recurrent seizures at 60 months or greater Intermittent oral levetiracetam vs placebo (any antipyretics) | no estimate extracted | NR | No studies |