Comparison of levetiracetam versus phenytoin for seizure prophylaxis in patients with traumatic brain injury: A meta-analysis

Introduction: Phenytoin (PHT) is used for seizure prophylaxis in patients with traumatic brain injury (TBI). However, levetiracetam (LEV) is emerging as an alternative. Hence in this study, we aimed to conduct a meta-analysis comparing these two drugs in patients with TBI. Methods: A systematic search in electronic databases was performed. Studies consistent with our purpose (comparing LEV vs. PHT for the prevention of seizures in TBI patients) were selected for our meta-analysis. We extracted data of all eligible studies on a standard abstraction sheets. Extracted data included patient’s demographics, study type, intervention, and outcome. We defined seizures as primary outcome. Results: 1184 unduplicated papers identified by our search of which 1106 were excluded by reading the abstract and titles. 72 papers were removed by reading the full text. Finally 6 studies (Cohort studies) were selected for analysis. There is no superiority of either these two drugs at preventing of seizures based on the point estimate’s odds ratio (OR) = 1.1 [95% confidence interval (CI) = 0.55-2.20]. Conclusion: PHT and LEV showed equal efficacy in prevention of seizures after TBI