en Pediatrics Pediatrics Original Article Original Article <span style="font-size:14px;"><span style="font-family:times new roman;"><span style="color:#0000FF;"><strong><em>Background:</em></strong> </span>Caffeine is widely used for prevention of apnea and helps successful extubation from mechanical ventilation. It facilitates the transition from invasive to noninvasive support and reduces duration of continuous positive airway pressure (CPAP) in preterm infants. The optimum caffeine dose in preterm infants has not been well-studied in terms of benefits and risks. We compared efficacy and safety of once versus twice-daily caffeine dose in premature infants.<br> <span style="color:#0000FF;"><strong><em>Methods</em></strong><em>:</em></span> This study was a randomized clinical trial conducted in Bu-Ali Sina Teaching Hospital, Sari. Patients with gestational age of <37 weeks were included. Both groups received 20 mg/kg loading dose of caffeine intravenously followed by maintenance dose of 5 mg/kg/day in group 1 or 2.5 mg/kg every 12 hours in group 2. Extubation failure, CPAP failure and possibly adverse reactions were evaluated.<br> <span style="color:#0000FF;"><strong><em>Results:</em></strong> </span>The mean of gestational age and birth weight were 32.27&plusmn;3.23 (weeks) and 1824.5&plusmn;702.54 (gr), respectively. The rate of extubation and CPAP failure and length of NICU stay were lower in twice-daily-group with no statistically significant difference. The means of O² saturations on the first three days of caffeine therapy were higher in twice-daily-group. Caffeine was generally safe and well tolerated.<br> <span style="color:#0000FF;"><strong><em>Conclusions:</em></strong></span> This study, which assayed short-term effects of caffeine, showed that twice daily caffeine maintenance dose was related to more benefits in facilitating extubation or prevention of CPAP failure in preterm infants. However, there was not statistically significant difference between two groups.</span></span><br> <p></p> Caffeine, Extubation failure, CPAP failure, Preterm infants 46 53 http://caspjim.com/browse.php?a_code=A-10-686-1&slc_lang=en&sid=1 Fatemeh Faramarzi faramarzif1984@gmail.com 100319475328460011107 100319475328460011107 No Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran Mohamadreza Shiran Mr.Shiran@gmail.com 100319475328460011108 100319475328460011108 No Immunogenetics Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Mohamadreza Rafati mrrafati@mazums.ac.ir 100319475328460011109 100319475328460011109 Yes Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran Roya Farhadi dr.royafarhadi@gmail.com 100319475328460011110 100319475328460011110 No Department of Pediatrics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Ebrahim Salehifar 100319475328460011111 100319475328460011111 No Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran Maryam Nakhshab 100319475328460011112 100319475328460011112 No Department of Pediatrics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.