Salivary Theophylline levels

Salivary Theophylline levels

Chereches-Panta P, Nanulescu MV, Culea M, et al. Reliability of salivary theophylline in monitoring the treatment for apnoea of prematurity. Journal of Perinatology (2007) 27, 709–712. Full Text | PDF

Objective: To evaluate the reliability of salivary levels of theophylline in monitoring therapy of apnoea of prematurity.

Study Design: Aminophylline was administered intravenously in 13 infants with apnoea, in a loading dose of 5 mg/kg and maintenance dose of 3 mg/kg, every 8 h. The patients were divided into two groups according to their postconceptional age (PCA): group A, of infants with small PCA (32.8 2.0 weeks; n=6 cases), and group B, infants with higher PCA (37.1 0.8 weeks; n=7 cases).

Results: A total of 57 paired samples of serum and saliva were obtained in all 13 infants. The mean serum level of theophylline was 7.8 5.8 g/ml and the ratio between serum and salivary concentration of theophylline was 1.53 0.28. A strong correlation between the serum and salivary concentration of theophylline (r=0.973) was found. Infants with small PCA had significant higher serum concentration of theophylline than those with higher PCA (10.6 vs 5.3 g/ml; P=0.0002). The difference between the mean ratios of serum/salivary theophylline levels in the two groups was low (1.44 vs 1.62; P=0.0155).

Conclusion: The strong correlation of theophylline in serum and in saliva recommends the salivary levels as a reliable method for monitoring the treatment of apnoea of prematurity.

Comments: It is very interesting to know that salivary and serum levels of theophylline correlate each other. Most of the centers are using serum levels because salivary levels are not available in labs of many centers. Also now many centers using caffeine instead of theophylline to treat apnea of prematurity. JMK

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