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Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
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Treatment of patent ductus arteriosus: indomethacin or ibuprofen?

Nehama Linder1, Rachel Bello, Adriana Hernandez

  • 1Department of Neonatology, Rabin Medical Center, Petach Tikva, Israel. linderm@netvision.net.il

American Journal of Perinatology
|December 17, 2009
PubMed

Insights

Ibuprofen and indomethacin are equally effective for treating patent ductus arteriosus (PDA) in preterm infants. However, ibuprofen is a safer choice, reducing risks of renal failure, low platelets, and hyponatremia.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pharmacology
  • Cardiology

Background:

  • Patent ductus arteriosus (PDA) is a common condition in preterm infants.
  • Pharmacological closure is a primary treatment strategy.
  • Comparing the safety and efficacy of different agents is crucial.

Purpose of the Study:

  • To compare the efficacy and safety of ibuprofen versus indomethacin for PDA treatment in preterm infants.
  • To evaluate potential adverse effects associated with each drug.

Main Methods:

  • Retrospective comparative study at a pediatric tertiary center.
  • Infants treated with indomethacin (2000-2003) were compared to those treated with ibuprofen (2003-2005).
  • Data on demographics, clinical outcomes, and laboratory values were analyzed.

Main Results:

  • Both ibuprofen and indomethacin demonstrated similar efficacy in closing PDA.
  • Indomethacin treatment was associated with significantly higher creatinine levels and increased incidence of hyponatremia and thrombocytopenia.
  • No significant differences were observed in other major outcomes like intraventricular hemorrhage, necrotizing enterocolitis, or mortality.

Conclusions:

  • Ibuprofen and indomethacin are equally effective for PDA closure in preterm infants.
  • Ibuprofen offers a safer profile, with a reduced risk of renal and hematological complications.
  • Ibuprofen is recommended as a preferred agent for pharmacological PDA treatment in this population.

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