Fig. 5: Treatment failure rate of midazolam and diazepam sub-grouped by Route of administration. | Pediatric Research

Fig. 5: Treatment failure rate of midazolam and diazepam sub-grouped by Route of administration.

From: Efficacy, safety, route of administration of midazolam and diazepam for pediatric status epilepticus: systematic review, meta-analysis, and trial sequential analysis

Fig. 5: Treatment failure rate of midazolam and diazepam sub-grouped by Route of administration.

The overall pooled analysis showed a statistically significant benefit for Midazolam, which was associated with a lower failure rate (RR = 0.74; 95% CI: [0.57, 0.95], p = 0.02; I2 = 36%, t2 = 0.04).Subgroup Analysis: significant efficacy favoring Midazolam was observed in the IV vs. IV comparison (RR = 0.28; 95% CI: [0.11, 0.71], p = 0.008) and the Buccal Midazolam vs. Rectal Diazepam comparison (RR = 0.66; 95% CI: [0.49, 0.88], p = 0.005; I2 = 39%, tau2 = 0.02). Conversely, no significant difference in failure rates was observed for IN/IM Midazolam vs. Rectal Diazepam (RR = 1.06; 95% CI: [0.65, 1.72], p = 0.81) or when comparing Non-IV Midazolam vs. IV Diazepam (RR = 1.01; 95% CI: [0.62, 1.62], p = 0.98). The test for subgroup differences was significant (p = 0.04, I2 = 64.6%), confirming that the choice of administration route significantly modifies the comparative efficacy.

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