Turk Kardiyol Dern Ars. Ahead of Print: TKDA-03902 | DOI: 10.5543/tkda.2020.03902
Positive tendency toward synchronous use of acetaminophen and ibuprofen in treating patients with patent ductus arteriosus
, Khadijeh Sadat Najib1
, Hamid Amoozgar2
, shahnaz pourarian1
, Mozhgan Moghtaderi11
Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran2
Department of Pediatric Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran
OBJECTIVES Spontaneous closure of ductus arteriosus often fails in premature newborns and this condition can be associated with increased morbidity and mortality. The practice of closure is performed at first pharmacologically with various nonsteroidal anti-inflammatory drugs. We conducted this study to determine whether combining acetaminophen with ibuprofen is more effective than taking each one separately in treatment of patent ductus arteriosus.
METHODS The present randomized, controlled trial study included 154 premature newborns with patent ductus arteriosus. The patients were randomized into three groups: acetaminophen receiving group (n=67), ibuprofen receiving group (n=68), and combination receiving group (n=19). Echocardiography was done before starting the medication and after completing the first or second courses of treatment. Blood markers were measured to describe the safety of three-designed therapy.
RESULTS After the first course of treatment, patent ductus arteriosus was closed in 76.1% of the infants in the acetaminophen group, 76.4% of those in the ibuprofen group, and 78.9% of the combination therapy group (P= 0.97). Closure rates after the second courses of treatment were 43.7% in the acetaminophen group, 62.5% in the ibuprofen group, and 100% in the combination group. The patients found no complication attributed to the three types of the treatment designed.
CONCLUSION Concomitant use of acetaminophen and ibuprofen can be an effective option for closure of patent ductus arteriosus. Other studies with larger sample size are recommended to be performed in order to confirm the results.
Acetaminophen, Ibuprofen, Neonate, Patent ductus arteriosus
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Corresponding Author: Mozhgan Moghtaderi, Iran