Hannalae Grace M. Dulay-See
Makati Medical Center, Philippines
Title: A retrospective cohort study to evaluate the use of paracetamol compared to ibuprofen in the medical closure of patent ductus arteriosus among preterm infants in a private tertiary hospital
Biography
Biography: Hannalae Grace M. Dulay-See
Abstract
Objective: To determine the effectiveness and safety of oral and intravenous paracetamol compared to oral ibuprofen in the closure of a PDA in preterm infants. Design: A retrospective cohort study was performed involving 28 cases of premature infants at a private tertiary hospital from January 1, 2010 to June 30, 2014. Each patient received either oral paracetamol at a dose of 15 mg/kg every 6 hours for 3 days or oral ibuprofen at an initial dose of 10 mg/kg followed by 5 mg/kg at 24 and 48 hours. Results: The PDA closure rates for both drugs were identical at 64.3% (9/14). The mean days of closure for the paracetamol group was shorter at 1.5 ±.46 days in contrast to the ibuprofen group which is 2.7 ±0.48 days.(P=0.00) There were no significant differences between the two groups in the incidence of adverse events. There were more preterms that had gastrointestinal bleeding in the ibuprofen group (28.6%) compared to paracetamol group (7.1%). (P=0.326). Platelet counts in the ibuprofen decreased after one week of treatment at -87±115.84, while that of paracetamol group increased by 12±92.34. (P=0.048) Conclusions: Paracetamol has its place with equal efficiency in the closure of PDA compared to ibuprofen which is the standard drug for the medical treatment of PDA. Paracetamol with its lower incidence of adverse events may replace ibuprofen as a drug of choice in the treatment of PDA in preterm infants.