Comparison of Caffeine Versus Aminophylline for Apnea of Prematurity

Objective: To make a comparison between the efficacy and safety of Caffeine and Aminophylline for Apnea of prematurity at standard doses.Methodology: The participants (neonates) were allocated randomly into 2 groups. Caffeine was given in loading dose of caffeine citrate (20 mg/kg) followed by 5 mg/kg/day maintenance dose every 24 hour to one group. The Aminopylline group was given (loading dose 5mg/kg and maintenance dose of 1.5 mg/kg) every 8 hour. The assesment for variations in the episodes of apnea, corresponding respiratory disorders, along with acute detrimental effects was done. The therapeutic drug levels related to the efficacy were also determined.Results: The mean apnea events/day in neonates administrated by caffeine was 0.8±0.3, 1.9±0.18, 1.4±1.8, 0.9±0.11 and 0.98±0.15 for 0, 1-3, 4-7, 8-14 and 15-21 days respectively. While, The mean apnea events/day in neonates administrated by Aminophylline was 0.6±0.4, 0.4±0.24, 0.3±1.6, 0.8±0.14 and 0.69±0.15 for 0, 1-3, 4-7, 8-14 and 15-21 days respectively. The difference was statistically significant for one to three days (p=0.000) and four to seven days (p=0.000), 15-21 days (p=0.004) While the difference was statistically insignificant at 0 day (p=0.845), 8-14 days (p=0.741).Conclusion: Results of our study revealed that caffeine is more effective than Aminophylline in treatment of apnea of prematurity. Keywords: Apneic spells, Methylxanthines, Preterm neonates