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Original ArticleOpen Access
A Comparison of Oral Ibuprofen and Intravenous Indomethacin for Closure of Patent Ductus Arteriosus in Preterm Infants
Chotigeat U 
,
Jirapapa K ,
Layangkool T
,
Jirapapa K ,
Layangkool T URAIWAN CHOTIGEAT, MD*,
KESANAT JIRAPAPA, MD**,
THANARA T LA YANGKOOL, MD***
Background : Indomethacin is widely accepted as the treatment for patent ductus arteriosus
(PDA) in preterm infants but it has various side effects. Ibuprofen is the alternative treatment and
believed to be less likely to induce side effects.
Objective : To compare efficacy and side effects of ibuprofen
versus
indomethacin treatment
for symptomatic patent ductus arteriosus (PDA) in preterm infants.
Method : The authors studied 30 infants (gestational age
~
35 weeks, aged
~
10 days) who
were diagnosed as having symptomatic PDA confirmed by echocardiogram. The infants were randomly
assigned to receive three intravenous doses of indomethacin given at 12 -hour intervals or three doses
of ibuprofen given at 24-hour intervals, starting within ten days of life. The demographic data, rate of
clinical closure, need for additional treatment, side effects, complications and the infants' clinical course
were recorded within 28 days.
Results : The rate of ductal closure was similar with the two treatment regimes. Ductal closure
occurred in 7 of 15 infants given ibuprofen (46.67%) and 10 of 15 infants given indomethacin (66.67%).
(Relative risk 0.669; 95% confidence interval, 0.328 to 1.364; p
=
0.462) The number of infants who
needed a second pharmacologic treatment was not significantly different between the two groups. (6
cases in the ibuprofen group, 5 cases in the indomethacin group) but surgical ligation was performed
in two cases in the indomethacin group. There was a significant difference in using the diuretic drug
(furosemide) in the indomethacin group (11 cases), compared to the ibuprofen group (3 cases), (p
=
0.009). More cases of necrotizing enterocolitis were seen in the indomethacin group (66.67% compared
to 40% in the ibuprofen group) but there was no statistically significant difference.
SS64
U. CHOTIGEAT
et
KESANAT JIRAPAPA, MD**,
THANARA T LA YANGKOOL, MD***
Background : Indomethacin is widely accepted as the treatment for patent ductus arteriosus
(PDA) in preterm infants but it has various side effects. Ibuprofen is the alternative treatment and
believed to be less likely to induce side effects.
Objective : To compare efficacy and side effects of ibuprofen
versus
indomethacin treatment
for symptomatic patent ductus arteriosus (PDA) in preterm infants.
Method : The authors studied 30 infants (gestational age
~
35 weeks, aged
~
10 days) who
were diagnosed as having symptomatic PDA confirmed by echocardiogram. The infants were randomly
assigned to receive three intravenous doses of indomethacin given at 12 -hour intervals or three doses
of ibuprofen given at 24-hour intervals, starting within ten days of life. The demographic data, rate of
clinical closure, need for additional treatment, side effects, complications and the infants' clinical course
were recorded within 28 days.
Results : The rate of ductal closure was similar with the two treatment regimes. Ductal closure
occurred in 7 of 15 infants given ibuprofen (46.67%) and 10 of 15 infants given indomethacin (66.67%).
(Relative risk 0.669; 95% confidence interval, 0.328 to 1.364; p
=
0.462) The number of infants who
needed a second pharmacologic treatment was not significantly different between the two groups. (6
cases in the ibuprofen group, 5 cases in the indomethacin group) but surgical ligation was performed
in two cases in the indomethacin group. There was a significant difference in using the diuretic drug
(furosemide) in the indomethacin group (11 cases), compared to the ibuprofen group (3 cases), (p
=
0.009). More cases of necrotizing enterocolitis were seen in the indomethacin group (66.67% compared
to 40% in the ibuprofen group) but there was no statistically significant difference.
SS64
U. CHOTIGEAT
et
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