Rectal aminophylline in the management of apnoea of prematurity.

Rectal suppositories as an alternative to intravenous aminophylline in the management of recurrent apnoea were studied in 41 preterm infants of mean gestation 28.3 weeks and mean birthweight 1176 g. Therapeutic blood concentrations were obtained two hours after a rectal loading dose of 10 mg/kg, with steady concentrations and maximum reduction in apnoeic episodes (from a mean of 0.5 per hour to 0.09 per hour) within 24 hours on a maintenance dose of 10 mg/kg/day. There was good correlation between the rectal dose and the plasma theophylline concentration. Several infants showed a significant reduction in Pco2 when treated with aminophylline. Side effects were related to the plasma theophylline concentration and were not seen at concentrations less than 14 mg/l.