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Comparison of Oral Acetaminophen Versus Ibuprofen in Premature Infants With Patent Ductus Arteriosus
Mohammad Mehdi Bagheri1, Pedram Niknafs1, Fatemeh Sabsevari1
1Afzalipour Medical Center, Kerman University of Medical Sciences, Kerman, IR Iran.
Insights
Oral acetaminophen and ibuprofen show similar efficacy in closing patent ductus arteriosus (PDA) in preterm infants. Acetaminophen is recommended due to fewer complications, offering a safer alternative for PDA treatment.
Area of Science:
- Neonatal Medicine
- Pharmacology
- Pediatric Cardiology
Background:
- Patent ductus arteriosus (PDA) is a significant cause of morbidity in preterm infants.
- Effective treatment of PDA is crucial for improving outcomes in premature neonates.
Purpose of the Study:
- To compare the efficacy of oral acetaminophen versus oral ibuprofen for PDA closure in preterm neonates.
- To evaluate acetaminophen as a potentially safer alternative to ibuprofen for PDA treatment.
Main Methods:
- A randomized clinical trial involving 120 preterm infants (<37 weeks gestation) with echocardiographically confirmed PDA.
- Infants received either oral acetaminophen (15mg/kg q6h for 3 days) or oral ibuprofen (20mg/kg initial, then 10mg/kg at 24 & 48h).
- Treatment efficacy was assessed via repeat echocardiography after treatment completion.
Main Results:
- After the first treatment course, PDA closure rates were 82.1% for acetaminophen and 75.8% for ibuprofen (P=0.38).
- Following a second course, closure rates were 50% for acetaminophen and 73.3% for ibuprofen (P=0.21).
- No statistically significant difference in efficacy was observed between the two drugs.
Conclusions:
- Oral acetaminophen and ibuprofen demonstrate comparable efficacy in closing PDA in preterm neonates.
- Acetaminophen is recommended as a preferred treatment option due to its favorable safety profile and minimal complications compared to ibuprofen.
- Acetaminophen presents a viable alternative for managing PDA in preterm infants, potentially reducing adverse effects associated with ibuprofen.
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.
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