Evaluating the Effectiveness of Ibuprofen Versus Acetaminophen in Closing Patent Ductus Arteriosus in Preterm...

Area of Science:

• Neonatal Medicine
• Pediatric Cardiology
• Pharmacology

Background:

• Patent Ductus Arteriosus (PDA) is a prevalent congenital heart defect in preterm infants, associated with significant morbidity and mortality.
• Intravenous (IV) ibuprofen is the established treatment, with IV acetaminophen considered an alternative, but its efficacy requires further investigation.
• Current evidence on acetaminophen's effectiveness for PDA closure in neonates is inconclusive.

Purpose of the Study:

• To compare the efficacy and safety of IV acetaminophen versus IV ibuprofen as initial therapy for PDA closure in preterm neonates.
• To evaluate the success rates of PDA closure between the two treatment groups.
• To assess the safety profiles of IV acetaminophen and IV ibuprofen in this vulnerable population.

Main Methods:

• A retrospective cohort study was conducted at a tertiary Saudi hospital.
• Included preterm neonates (gestational age ≤32 weeks) diagnosed with PDA and treated with either IV ibuprofen or IV acetaminophen.
• Primary outcome: efficacy of ibuprofen vs. acetaminophen for PDA treatment, assessed via ultrasound confirmation of closure.

Main Results:

• 95 treatment courses were analyzed: 49 received IV ibuprofen, and 18 received IV acetaminophen.
• PDA closure rates were 71.4% (35/49) for ibuprofen and 55.6% (10/18) for acetaminophen.
• The difference in closure rates was not statistically significant (p=0.35), and both treatments exhibited comparable safety.

Conclusions:

• IV ibuprofen demonstrated a trend towards higher PDA closure rates compared to IV acetaminophen in preterm neonates.
• No statistically significant difference in efficacy was found between the two treatments.
• Both IV ibuprofen and IV acetaminophen appear to have comparable safety profiles for initial PDA treatment, warranting further research into optimal acetaminophen dosing.