Comparison of Oral Acetaminophen Versus Ibuprofen in Premature Infants With Patent Ductus Arteriosus|
Bagheri, Mohammad Mehdi; Niknafs, Pedram; Sabsevari, Fatemeh; Torabi, Mohammad Hosein; Bijari, Bahareh Bahman; Noroozi, Elahe & Mossavi, Hamid
Background: Patent ductus arteriosus (PDA) is a common cause of morbidity. The aim of this study was to compare the efficacy of
oral Acetaminophen and oral Ibuprofen for the closure of patent ductus arteriosus (PDA) in preterm infants.
Objectives: This study demonstrated that, there was no significant difference between treatment of PDA with either oral Acetaminophen
or oral Ibuprofen in preterm neonates.
Patients and Methods: This clinical trial, randomized study, enrolled 120 infants, with a gestational age of < 37 weeks, who were admitted
in neonatal intensive care unit of Afzalipour hospital, Kerman, Iran, in 2014. PDA was confirmed echocardiographically. The
trial was registered in Iranian registry of clinical trials (Reg. No. 25542). Sixty-seven infants received oral Acetaminophen (15mg/kg
every six hours for three days) and 62 infants received Ibuprofen (an initial dose of 20 mg/kg, followed by 10 mg/kg at 24 and 48
hours). To evaluate the efficacy of the treatment, a second echocardiography was done after completing the treatment.
Results: After the first course of the treatment, PDA closed in 55 (82.1 %) patients who received oral Acetaminophen vs. 47 (75.8 %) of
those given oral Ibuprofen (P = 0.38). After the second course of treatment, PDA closed in 50 % of oral Acetaminophen group and
73.3% of oral Ibuprofen group (P = 0.21).
Conclusions: This study demonstrated that, there was no significant difference between treatment of PDA with either oral Acetaminophen
or oral Ibuprofen in preterm neonates. Oral Ibuprofen can effectively close PDA but is unfortunately associated with
some adverse effects limiting its utility thus we studied an alternative drug with similar efficacy and less adverse effects. This study
has recommends Acetaminophen with minimal complications for the treatment of PDA in preterm neonates instead of Ibuprofen.
Patent Ductus Arteriosus (PDA); Neonatal Intensive Care Unit (NICU); Acetaminophen; Ibuprofen; Echocardiography