A randomized, controlled, double-blind trial comparing two loading doses of aminophylline

Objective: To compare 8 mg/kg and 6 mg/kg loading doses of aminophylline. Study design: Sixty-one preterm infants weighing <1500 g were enrolled once a decision to administer intravenous aminophylline was made. A standard maintenance dose was used. Serum levels of theophylline were drawn 8 hours after the loading dose and before the fifth maintenance dose. Results: After the initial loading dose, the 8 mg/kg group achieved recommended serum theophylline levels (7-12 μg/ml) more frequently than the 6 mg/kg groups (39% vs 3%, p=0.002). Subsequent levels were similar between the groups. There were no increases in side effects with the higher loading dose. Conclusion: If a clinical decision to start intravenous aminophylline therapy in preterm infants has been made, the use of an 8 mg/kg loading dose appears to be a better and safe way to quickly achieve serum theophylline levels within the recommended range.