Dalziel SR, et al. - For second-line treatment in pediatric convulsive status epilepticus, researchers assessed if levetiracetam was superior to phenytoin. They included children between 3 months and 16 years of age with convulsive status epilepticus who already failed first-line benzodiazepine treatment. They were randomized (1:1) to get 20 mg/kg phenytoin (intravenous or intraosseous infusion over 20 min) or 40 mg/kg levetiracetam (intravenous or intraosseous infusion over 5 min), after being stratified by site and age (≤5 years, >5 years). In 68 (60%) patients in the phenytoin group and 60 (50%) patients in the levetiracetam group they saw clinical cessation of seizure activity 5 minutes following completion of the infusion of the study drug. Other than one death not thought to be due to the study drug, there were no serious adverse events. For second-line management of these patients, levetiracetam was not deemed to be superior to phenytoin.