Comparison of oral acetaminophen with oral ibuprofen on closure of symptomatic patent ductus arteriosus in preterm neonates

Patent ductus arteriosus (PDA) is a common cause of morbidity in premature neonates. The purpose of this study was to compare the efficacy of oral ibuprofen and oral acetaminophen to closure of symptomatic PDA, in premature neonates with gestational age (GA) ≤32 weeks.

This study was a randomized clinical trial with forty preterm neonates who were admitted in neonatal intensive care unit with symptomatic PDA and GA ≤32 weeks or birth body weight ≤1500 g. Twenty neonates received oral acetaminophen [Group A] and twenty neonates received oral ibuprofen [Group B] and compared with echocardiography finding each groups for closed PDA before and after treatment regiment.

Our results showed that the primary closure rate of PDA was 70% (95% confidence interval [CI]: 49.9%–90%) and 65% (95% CI: 54.3%–75.7%) in the acetaminophen and ibuprofen groups, respectively, and statistically no significant difference was observed between the two groups (P = 0.74).

These findings suggest that there was no significant difference between the effectiveness of oral acetaminophen and oral ibuprofen on closing of PDA, but less adverse effects and contraindication for acetaminophen make it reasonable choice for the treatment of symptomatic PDA.