International Journal of Clinical Pharmacy

, Volume 39, Issue 5, pp 998–1003 | Cite as

Levetiracetam versus phenytoin for seizure prophylaxis in brain injured patients: a systematic review and meta-analysis

  • Anis ChaariEmail author
  • Alaa Sayed Mohamed
  • Karim Abdelhakim
  • Vipin Kauts
  • William Francis Casey
Review Article


Background The onset of early and/or late seizures in brain injured patients is associated with worse outcome. So far, phenytoin is the most commonly used antiepileptic drug to prevent seizures in this group of patients. Objective In the current metaanalysis, we aimed to compare the efficacy and safety of phenytoin versus levetiracetam for seizure prophylaxis in brain injured patients. Methods A systematic search was conducted in PubMed and Cochrane Library Database by 2 investigators. Four randomized controlled trials (RCTs) were included (295 patients). Data were extracted and the quality of each RCT was assessed. Results Levetiracetam was found to be more effective than phenytoin in seizure prophylaxis (OR = 0.23; CI 95% [0.09–0.56]; Q test p value = 0.18 and I2 = 38%). A trend toward less serious side effects was also found in patients treated with levetiracetam (OR = 0.27; CI 95% [0.07–1.07]; Q test p value = 0.72 and I2 = 0%). Conclusion Levetiracetam is more effective and safer than phenytoin for seizure prophylaxis in brain injured patients.


Efficacy Levetiracetam Phenytoin, Prophylaxis Side effects Seizure 


Conflicts of interest



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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.King Hamad University HospitalMuharraqBahrain

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