Hüseyin Bahadır ŞENOL, Kaan Furkan BIYIK, Çağatay GÜNAY, Gökay GEDİK, Gazi ARSLAN, Fatma Ceren SARIOĞLU, Ayşe İpek POLAT, Adem AYDIN, Ayşe Semra HIZ, Uluç YİŞ
Turkish Archives of Pediatrics - 2026;61(7):601-607
Objective: This study aimed to evaluate the neurological and systemic outcomes of amantadine treatment in the acute phase of severe traumatic brain injury (TBI) in children. In addition, the potential factors associated with functional outcomes were analyzed. Methods: This retrospective cohort study analyzed data of pediatric patients with severe TBI. Amantadine treatment was administered to all patients who presented after 2022. The treatment protocol was initiated on the third day of hospitalization, at a daily dose of 6 mg/kg, and at 100 mg twice daily for older children. The Functional Status Scale (FSS) was used to assess mental status, vision, hearing, communication, motor abilities, respiration, and feeding both at discharge from intensive care unit (ICU) and again 6 months after the incident of TBI. Results: In this study, 60 patients had a median age of 14.5 years (IQR 8; range 2-17 years), while 32 patients received amantadine treatment. The length of median ICU stay and hospital stay were 11 and 20 days, respectively. At the 6-month follow-up, there was a significant improvement in FSS scores compared to those estimated at ICU discharge (P < .001), but no significant difference was observed between the amantadine and non-amantadine groups in terms of functional recovery, and inotrope requirement was identified as an independent risk factor for poor neurological outcome. Conclusion: Administration of amantadine did not provide a significant functional benefit. However, craniectomy was performed less frequently for patients who received amantadine. Amantadine treatment was well tolerated with a favorable safety profile.
