Change in the strategy for prophylactic diazepam use for febrile seizures and the impact on seizure recurrence within 24 h

Abstract Purpose To investigate the association between reduced prophylactic diazepam usage and short-term recurrence of febrile seizures (FSs) after the FS practice guideline was updated in Japan. Method In this single-center, retrospective study, children (6–60 months of age) with FS who were transported to our center by ambulance from January 2011 through December 2018 were included. Rectal administration of diazepam (0.3-0.5 mg/kg) after the first seizure and seizure recurrence within 24 h were compared between 2011–2015 (pre-guideline revision) and 2016–2018 (post-guideline revision). Results Among the total of 509 children, 297 were transported to our hospital in 2011–2015 and 212 in 2016–2018. Rectal diazepam administration was decreased in 2016–2018 (17 %) compared to 2011–2015 (53 %, P  Conclusion The FS practice guideline revision was associated with reduced prophylactic diazepam usage and increased FS recurrence within 24 h in Japan. Prophylactic diazepam use should be determined based on clinical safety, local health infrastructure, and parental anxiety.