Relative roles of phototherapy and phenobarbitone in treatment of nonhaemolytic neonatal jaundice

Trials were carried out on 61 infants with plasma bilirubin over 15 mg/100 ml to compare effects of phototherapy alone, phenobarbitone by injection, and both treatments combined. Infants above 2·5 kg birthweight treated with phenobarbitone only behaved like untreated controls up to 60 hours, and only at 84 hours was a significant fall seen. Infants of 2·5 kg birthweight or less treated with phenobarbitone had significantly higher levels throughout the 84 hours of study. Phototherapy, either alone or combined with phenobarbitone, had its expected significant effect from 24 hours onwards in both groups of infants. Combined phototherapy and phenobarbitone treatment showed no difference from phototherapy alone. Phenobarbitone has no place in the management of established jaundice. Risks of phenobarbitone therapy and a possible explanation of contradictory results in previous trials are discussed. No changes were found in packed cell volumes, plasma albumin level, or residual albumin binding capacity at 48 hours from onset of treatment or between groups.