Comparison of the Effect of Oral Acetaminophen and Ibuprofen on Patent Ductus Arteriosus Closure in Premature Infants Referred to Hajar Hospital in Shahrekord in 2016-2017
Background and Aim: Arterial duct in term infants is closed 96 h after birth in normal conditions. In some cases, especially in preterm infants, this duct is not closed after birth, which is called patent ductus arteriosus (PDA). This disease, if left untreated, leads to depressed respiratory capacity and shunt in preterm infants. The aim of this study was to compare the effect of oral acetaminophen and ibuprofen on PDA closure in preterm infants. Materials and Methods: In this clinical trial, 50 infants with a gestational age of < 37 weeks with PDA, confirmed by echocardiography and clinical symptoms, were selected and randomly divided into two groups of 25. One group was orally given acetaminophen at 10 mg/kg body weight (BW) every 6 h for 72 h, and another group received ibuprofen at 10 mg/kg BW on the 1st day and then 5 mg/kg on the 2nd and 3rd days. Before and after the intervention, infants were examined for possible side effects using echocardiography. Results: According to the results before and after the intervention, the PDA diameter was not statistically significant difference between the two treatment groups (P = 0.328 and P = 0.602). Frequency and percentage of the closure of PDA in acetaminophen group were 23 (92%) and in the ibuprofen group 22 (88%) with no statistically significant difference (P = 1.000). The mean levels of blood urea nitrogen, creatinine, and aspartate aminotransferase were not significantly different between the two groups; however, the mean of alanine aminotransferase was higher in the acetaminophen group (P < 0.05). Urine output was normal in both groups; however, the frequency of gastrointestinal complications was higher in the ibuprofen group than in the acetaminophen group (P < 0.05). Conclusion: The results of this study indicate better or equal efficacy of acetaminophen in comparison to ibuprofen to close PDA
