Publication:

Safety and efficacy of use of aminophylline and caffeine in management of apnea of prematurity

Background Both aminophylline and caffeine have been used to manage apnea of prematurity in various NICUs. We aimed to investigate the efficacy and safety of these two drugs in the mentioned scenario.

Methods This randomized controlled trial was carried out from July 2024 to June 2025 in the ICMH, Dhaka. All the preterm newborns with ≤ 34 completed weeks of GA were enrolled. Those having major congenital anomalies, respiratory depression from medications and patent ductus arteriosus (PDA) as a cause of apnea were excluded. Among 53 participants, 27 received caffeine and 26 received aminophylline.

Results In the caffeine group average gestational age was 33.1 days and the birth weight was 1330 grams. On average, treatment was started at 2.5 days and was continued for 18 days. While in the aminophylline group average gestational age was 32.8 days and the birth weight was 1402 grams. On average, treatment was started at 4.1 days and was continued for 21 days. The aminophylline group observed relatively more apneic spells and other adverse effects. Except for treatment starting days, neither of the changes in these groups was statistically significant.

Conclusions Regarding effectiveness and safety, caffeine exerted as much performance as aminophylline without any superiority of one over the other.