Abstracts

Rationale: Levetiracetam (LEV) is widely used in the inpatient setting for seizure prophylaxis and treatment, including in patients with brain injury. LEV is an excellent choice as an antiepileptic drug (AED) because of its tolerability and minimal interaction with other medications. However, the safety and efficacy of intravenous (IV) LEV have not been extensively studied in a large inpatient population. Methods: We conducted a retrospective chart review of all consecutive adult patients admitted to Tampa General Hospital (TGH) between September 10, 2006 and April 18, 2007 who received IV LEV. Dose, duration of therapy and adverse events of IV LEV were identified. Other data that was abstracted from the charts include admitting service, admission diagnosis, prior AED use, AED level and reason for AED therapy. Data will be analyzed using descriptive statistics. Data collection is currently ongoing. Results: Forty-nine patients were randomly selected. The age range of the patients was 19 - 94 years with a mean age of 54.3 years. The majority of patients (63.3%) were admitted to the neurology or neurosurgery services. Nineteen patients (38.8%) were on other AEDs prior to administration of IV LEV. Four of the 19 patients (21%) with readily available serum levels had sub-therapeutic AED levels. Patients tolerated IV LEV well and IV LEV was discontinued in only 2 patients (4.1%) secondary to adverse events. Intravenous LEV was discontinued in 4 patients (8.2%) for unknown reasons. Two patients (4.1%) had breakthrough seizures while on IV LEV, requiring other AEDs or additional IV LEV. Twelve patients (24.5%) expired while on IV LEV, all of whom were made comfortable at the family’s request. Conclusions: LEV is a commonly used AED for the treatment of partial seizures and seizure prophylaxis in an inpatient setting. Intravenous LEV presents an excellent alternative in patients who are unable to receive the oral formulation. Intravenous LEV was highly efficacious (95.9%) in treatment and prevention of seizures in our patient population. The discontinuation rate for IV LEV secondary to adverse events was extremely low (4.1%). We plan to review all patients receiving IV LEV at TGH during the aforementioned time frame in the near future.