Therapeutic difference in some treatment modalities of jaundice in Egyptian neonates

Abstract

Background: Jaundice is a significant problem in the early neonatal period due to excessive destruction of red blood cells or immature liver enzymes detoxifying bilirubin which may lead to neurotoxicity and brain damage in severe cases. Patients and Methods: A prospective clinical trial study was conducted on 120 neonates in neonatal Intensive Care Unit at Tanta University Hospital from May 2014 to August 2015. All of them suffering from neonatal jaundice. All of them received phototherapy, sixty of them (Group I) received phenobarbitone, and sixty of them (Group II) received fenofibrate. Results: There was no statistically significant difference between the two studied groups as regard total serum bilirubin (TSB) at time of admission (peak of TSB) P = 0.8, while there was a high statistical significant difference between both groups as regard TSB after 24 h P = 0.000, TSB after 48 h P = 0.000, and TSB at time of discharge (TSBD) P = 0.000, mean of TSB at time of admission is 17.9 ± 2.2 mg/dl in Group I and 18 ± 2.3 mg/dl in Group II, mean of TSB after 24 h is 16.3 ± 0.9 mg/dl in Group I and 11.5 ± 2.4 mg/dl in Group II, mean of TSB after 48 h is 12.8 ± 3 mg/dl in Group I and 6.7 ± 1.7 mg/dl in Group II, and finally mean of TSBD is 9.2 ± 0.6 mg/dl in Group I and 6.5 ± 1.4 md/dl in Group II. Conclusion: We concluded that oral fenofibrate in a dose of (10 mg/kg single dose) with phototherapy is more effective than oral phenobarbitone in a dose of (3 mg/kg/day for 3 days) with phototherapy in neonatal jaundice, so oral fenofibrate in this dose-treated neonatal jaundice more effective than oral phenobarbitone with avoidance of most of its side effects.