Treatment of neonatal hyperbilirubinemia with repetitive oral activated charcoal as an adjunct to phototherapy

The efficacy of multiple dose oral activated charcoal (OAC) therapy for neonatal hyperbilirubinemia was prospectively studied in 30 jaundiced newborns receiving phototherapy, randomly assigned to a study group (n = 14) or control group (n = 16). The study group received OAC before meals with a total amount of 8.5 ± 0.85 gms (M + SEM). Serum bilirubin levels upon initiation of phototherapy were (M ± SEM) 265 ± 8 and 253 ± 4 µmol/L respectively. After 24 hours there was no significant decrease in serum bilirubin levels in the control group (M ± SEM = 240 + 8 µmol/L) but bilirubin levels of the study group decreased (M + SEM = 235 ± 7 µmol/L, p < 0.02). At 48 hours serum bilirubin levels were significantly lower than baseline values in both groups. However, the decline in bilirubin levels in the study group (M + SEM = 56 + 10 µmol/L) was greater than that of the controls (M + SEM = 21 + 10 µmol/L p < 0.02). Oral activated charcoal seems to be an effective adjunct to phototherapy in the treatment of neonatal hyperbilirubinemia.