Patent ductus arteriosus treatment in preterm neonates, which is the drug of choice paracetamol vs ibuprofen?

Abstract

Background Patent ductus arteriosus (PDA) is one of the most prevalent problems in preterm infants. Although ibuprofen represents one of the choices for the closure of PDA, this treatment can cause severe gastrointestinal and adverse renal effects and worsen platelet function. Effective therapy for PDA had been suggested as paracetamol. Aim Our study is aiming to compare the efficacy and safety of paracetamol and ibuprofen. Patients and methods A prospective observational, single-center study was performed from December 2016 until August 2017, at ElGalaa Teaching Hospital in Cairo. In this study we included neonates with a gestational age of 28–36 weeks, diagnosed with a significant hemodynamically PDA using clinical and ultrasonographic cardiac evaluation. The pediatric cardiologist performed an echocardiographic examination before the start of the treatment and after seven days. Results We found that paracetamol had good efficacy on PDA in preterm infants, and the closure rate of paracetamol was comparable to that of ibuprofen. Conclusion Paracetamol may confer comparable treatment efficacy for the closure of PDA to ibuprofen, although paracetamol is associated with lower risk of adverse events.