Utility of antiepileptic drug monitoring in the pediatric XXXX .

@entity1 @entity410 @entity137 @entity341 @entity302 @entity159
@entity410 are common in the pediatric age group, and measurement of serum concentration of an antiepileptic drug (AED) is frequently ordered for @entity302 @entity1 in the @entity341 ( @entity341 ). The objective of this study was to develop a better understanding of the indications for, and consequences of, monitoring AED serum concentrations in the pediatric @entity341 . Charts of 116 @entity1 who visited the @entity341 and were tested for blood levels of AED were retrospectively reviewed. Main outcome measures were number and percentage of levels outside the therapeutic range, discontinuation of an AED or introduction of a new one, dosage modifications, and admission to hospital. Two pediatricians and a pediatric neurologist aware only of @entity1 ' age, weight, diagnosis, history, clinical presentation, and drug details reviewed each case and on the basis of predetermined criteria decided whether measurement of AED was indicated. Mean age (+/- SD) of the study population was 7 +/- 5 years (range, 2 months-17 years). Forty-two @entity1 (36%) were on monotherapy, and 74 (64%) were on polytherapy. Sixty-eight @entity1 (59%) presented with increased @entity410 frequency, 7 (6%) with @entity159 , and 13 (11%) with suspected AED @entity137 . The remainder of the @entity1 presented with problems unrelated to @entity302 . No significant difference was found between @entity1 with AED levels within the therapeutic range and those with levels outside it in the proportion of @entity1 needing dosage change, change in medication, or hospital admission (P = 0.5, 0.8, and 0.8, respectively). None of the @entity1 presenting with @entity159 and only 15% of those with increased @entity410 activity had subtherapeutic levels. Review of the cases suggested that measuring serum AED level was not indicated in 57 (49.1%) @entity1 . In the pediatric @entity341 , abnormal AED levels do not correlate with clinical management. Before ordering tests, physicians should consider whether their results would alter @entity1 treatment.
