OBJECTIVES: Afebrile seizures are referred as high risk vitamin D deficiency disease in children. Aim of our study was to evaluate prescribing trends of adjunctive vitamin D therapy in afebrile seizures in children with comparison to standard guideline.

METHODS: Cross sectional observational study was carried out on children at out-patient department of Pakistan Institute of Medical Sciences Islamabad, Pakistan from December 2017 to May 2018. Children’s age ≥ 2 to 12 years prescribed with vitamin D in afebrile seizures randomly selected for study. Data were collected by self-designed data collection pro-forma from child’s medical record regarding vitamin D testing and prescribed dose. Prescribing trends of adjunctive vitamin D therapy was evaluated by recommendations of U.S endocrinology guideline of vitamin D deficiency. Descriptive statistical analysis was done by SPSS (IBM version 25).

RESULTS: Among 132 afebrile seizures patients, 127 (96.2%) patients, 25-hydroxy vitamin D testing was not recommended according to guideline. Adherence to vitamin D testing found in 5 (3.7%) patients. Adjunctive vitamin D dose was prescribed according to guideline in 14 (10.6%) patients. Among 114 (86.3%) patients prescribed vitamin D dose was less than empirical dose (350-700 IU). Adjunctively vitamin D dose (350-1000 IU) was prescribed with phenobarbitone, levetiracetam, phenytoin, diazepam, carbamazepine in afebrile seizures in the treatment regimen.

CONCLUSIONS: . Evidence based prescribing of adjunctive vitamin D therapy was not followed in term of vitamin D testing and prescribed dose. Overall, poor adherence of adjunctive vitamin D therapy according to standard guideline was found in afebrile seizures in children.